微波原位灭活肿瘤复合开放椎体成形、钉棒内固定治疗胸椎转移瘤的临床近期效果

发布时间：2018-10-15 16:42

【摘要】：目的探讨胸椎转移瘤微波原位灭活肿瘤复合开放椎体成形、钉棒内固定治疗的有效性及安全性。方法选取符合条件的胸椎转移瘤患者17例,采用微波原位灭活肿瘤复合开放椎体成形、钉棒内固定治疗,记录术中手术时间,术中出血,术中骨水泥渗漏,比较术前及术后1个月疼痛评分(NRS评分),Frankel脊髓损伤评估,功能状态卡式评分(KPS评分)。结果 17例患者平均手术时间为(284.71±51.25)min,术中平均失血为(2 258.82±1 353.72)mL,术中骨水泥渗漏为11.8%,术中无相关临床并发症。NRS评分术前平均为(5.18±2.04)分,术后1个月平均为(2.82±1.59)分,治疗前后比较差异有统计学意义(P0.05)。神经损伤评估D、E级比例由治疗前52.9%升高到88.2%,治疗前后差异有统计学意义(P0.05)。KPS评分(80~100)由术前17.6%提升为58.8%,治疗前后比较差异有统计学意义(P0.05)。结论微波原位灭活肿瘤复合开放椎体成形、钉棒内固定治疗胸椎转移瘤是一种潜在可选择的治疗方式,尚需大样本临床研究论证。
[Abstract]:Objective to investigate the efficacy and safety of microwave in situ inactivation of thoracic vertebral metastases combined with open vertebroplasty and screw rod fixation. Methods 17 patients with thoracic vertebral metastases were selected and treated with microwave in situ inactivated tumor combined with open vertebroplasty, screw rod internal fixation, operative time, intraoperative bleeding and bone cement leakage. The pain scores (NRS score,), Frankel spinal cord injury assessment, functional state card scale (KPS) were compared before and 1 month after operation. Results the mean operative time of 17 patients was (284.71 卤51.25) min,. The mean blood loss during operation was (2 258.82 卤1 353.72) mL,. There were no related clinical complications in 17 patients. The average NRS score was (5.18 卤2.04) before operation and (2.82 卤1.59) at one month after operation. The difference before and after treatment was statistically significant (P0.05). The percentage of nerve injury assessment grade E increased from 52.9% before treatment to 88.2%. There was significant difference before and after treatment (P0.05). KPS score (80,100) increased from 17.6% before treatment to 58.8% before treatment (P0.05). Conclusion Microwave in situ inactivation of tumor combined with open vertebroplasty and screw rod fixation is a potential treatment for thoracic vertebral metastases, which needs a large number of clinical studies.
【作者单位】：广西医科大学附属肿瘤医院骨软组织神经外科;
【分类号】：R738

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