经皮椎体成形术联合低温等离子消融治疗胸腰椎转移瘤的临床研究.docVIP

经皮椎体成形术联合低温等离子消融治疗胸腰椎转移瘤的临床研究 　　[摘要] 目的 探讨椎体成形联合低温等离子消融技术治疗胸腰椎转移瘤的临床效果。 方法 选取2010年1月～2015年6月于浙江金华广福医院骨科就诊且临床影像和病理确诊为恶性肿瘤胸腰椎转移瘤患者20例，行局麻下经皮微创椎体成形术联合低温等离子消融治疗。比较患者术前、术后视觉模拟评分（VAS），观察CT及X线片结果。 ?Y果 20例手术均获得成功，术后2 h佩戴腰围带下地活动，随访12～30个月，平均18个月，术后患者胸腰部疼痛明显减轻，VAS评分由术前（6.9±0.9）分降至术后（1.6±0.8）分（P 0.05），生活质量得到显著提高，复查CT及X线片提示病灶骨水泥填充满意，无渗漏。 结论 经皮椎体成形术联合低温等离子消融术对于局限于椎体的溶骨性转移病灶恶性肿瘤患者是一种创伤小、疗效确切的手术方法，能够缓解疼痛，改善患者生活质量，减少局部病灶复发。 　　[关键词] 经皮椎体成形术；等离子消融；胸腰椎转移瘤；癌痛 　　[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210（2018）02（c）-0071-04 　　Clinical study of percutaneous vertebroplasty combined with hypothermia plasma ablation in the treatment of thoracolumbar metastasis 　　LENG Yankui HOU Liqiang CAO Zhiqiang WANG Qiang WANG Haomin 　　Department of Orthopedics， Zhejiang Jinhua Guangfu Hospital， Zhejiang Province， Jinhua 321000， China 　　[Abstract] Objective To explore the clinical effect of percutaneous vertebroplasty combined with hypothermia plasma ablation in the treatment of thoracolumbar metastasis. Methods A total of 20 patients with malignant tumor thoracolumbar metastasis diagnosed by clinical imaging and pathology in Department of Orthopedics， Zhejiang Jinhua Guangfu Hospital from January 2010 to June 2015 were selected， and they were treated with percutaneous minimally invasive vertebroplasty combined with hypothermia plasma ablation under local anesthesia. The visual analogue scale （VAS） before and after operation was compared， and the results of CT and X-ray were observed. Results All 20 cases gained successfull operation， they could move around by wearing a waist belt after operation for 2 h. They were followed-up for 12-30 months， with an average of 18 months. Postoperative thoracic waist pain was significantly reduced. The VAS score was reduced from （6.9±0.9） points before operation to （1.6±0.8） points after operation （P 0.05）. The quality of life was improved significantly. The reexamination of CT and X-ray showed that the bone cement was filled satisfactorily， with no leakage. C