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[1]謝煒星,萬超,晉大祥,等.經(jīng)皮椎體強(qiáng)化術(shù)治療脊柱溶骨性腫瘤[J].中醫(yī)正骨,2015,27(09):50-53.
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經(jīng)皮椎體強(qiáng)化術(shù)治療脊柱溶骨性腫瘤()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年09期
頁碼:
50-53
欄目:
臨床報(bào)道
出版日期:
2015-09-30

文章信息/Info

作者:
謝煒星萬超晉大祥丁金勇徐繼禧馬輝張順聰梁德
廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院,廣東 廣州 510405
關(guān)鍵詞:
脊椎腫瘤 椎體成形術(shù) 椎體轉(zhuǎn)移瘤 多發(fā)性骨髓瘤
摘要:
目的:觀察經(jīng)皮椎體強(qiáng)化術(shù)治療脊柱溶骨性腫瘤的臨床療效。方法:2012年1月至2014年4月,采用經(jīng)皮椎體強(qiáng)化術(shù)治療脊柱溶骨性腫瘤患者17例45椎,男10例、女7例。年齡26~87歲,中位數(shù)60歲。脊柱轉(zhuǎn)移瘤9例20椎,其中原發(fā)肺癌轉(zhuǎn)移6例15椎,子宮頸癌轉(zhuǎn)移1例2椎,腦膜惡性黑色素瘤轉(zhuǎn)移1例2椎,原發(fā)病灶不明確1例1椎; 多發(fā)性骨髓瘤8例25椎。按照美國東部腫瘤協(xié)作組(eastern cooperative oncology group,ECOG)體力狀態(tài)分級(jí),4級(jí)6例、3級(jí)8例、2級(jí)1例、1級(jí)2例。所有患者均經(jīng)CT檢查確定椎體存在溶骨性破壞或成骨溶骨混合性破壞; 均經(jīng)非手術(shù)治療后嚴(yán)重疼痛無法緩解。術(shù)后隨訪觀察疼痛改善、體力狀態(tài)改善情況。結(jié)果:15例行經(jīng)皮椎體成形術(shù),2例行經(jīng)皮椎體后凸成形術(shù)。骨水泥注入量(5.12±1.85)mL。所有患者均獲得隨訪,隨訪時(shí)間8 d至30個(gè)月,中位數(shù)6個(gè)月。5例患者死亡,其中術(shù)后8 d死亡1例、術(shù)后3個(gè)月死亡2例、術(shù)后6個(gè)月死亡1例、術(shù)后12個(gè)月死亡1例。疼痛視覺模擬評(píng)分由術(shù)前(8.0±1.5)分降至術(shù)后(2.8±1.2)分、術(shù)后1個(gè)月(2.1±2.1)分、術(shù)后3個(gè)月(1.8±1.5)分。術(shù)后1個(gè)月患者ECOG體力狀態(tài)分級(jí),4級(jí)2例、3級(jí)4例、2級(jí)5例、1級(jí)5例。20個(gè)脊柱轉(zhuǎn)移瘤椎體中有13個(gè)椎體發(fā)生骨水泥滲漏,25個(gè)多發(fā)性骨髓瘤椎體中有10個(gè)椎體發(fā)生骨水泥滲漏; 所有患者均未因骨水泥滲漏引起臨床癥狀需進(jìn)一步處理。結(jié)論:采用經(jīng)皮椎體強(qiáng)化術(shù)治療脊柱溶骨性腫瘤,可以緩解疼痛癥狀,改善體力狀態(tài),提高患者的生活質(zhì)量,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
2015-01-23收稿 2015-03-20修回
更新日期/Last Update: 2015-09-30