肺癌脊柱转移瘤的手术疗效分析

目的探讨肺癌脊柱转移瘤的手术治疗效果。 方法回顾性分析2012年1月至2016年5月在浙江大学附属第二医院骨肿瘤中心及浙江省嘉兴市第二医院骨科住院治疗且病理诊断明确的肺癌脊柱转移瘤患者72例。其中男性48例（66.7%），女性24例（33.3%），平均年龄（61±4）岁，39例（54.2%）术前生存期评分为6分，27例（37.5%）7分，6例（8.3%）8分。随访并比较患者手术前后疼痛视觉模拟评分（VAS）及Frankel分级变化情况，评价手术疗效。 结果65例患者获得满意随访（90.2%）。随访时间6~12个月，平均（8.5±1.6）个月，VAS评分由术前（5.9±1.1）分降至术后（2.7±1.2）分，差异有统计学意义（t=21.24，P<0.05）。术后Frankel分级明显改善，差异有统计学意义（Z=-4.978，P<0.05），42例术前有神经功能障碍者5例未恢复，37例部分恢复，差异有统计学意义（Z=-4.978，P<0.05）。 结论手术治疗肺癌脊柱转移瘤可有效缓解患者疼痛程度，改善神经功能。

The curative effect of surgical treatment for spinal metastases of lung cancer

ObjectiveTo investigate the curative effect of surgical treatment for spinal metastases of lung cancer. MethodsA retrospective study was performed in 72 cases of spinal metastases of lung cancer treated in The Second Affiliated Hospital of Zhejiang University and The Second Hospital of Jiaxing. There were 48 males (66.7%) and 24 females (33.3%) with an average age of 61±4 years. The preoperative survival score were evaluated and 39 cases (54.2%) were 6 points, 27 cases (37.5%) were 7 points and 6 cases (8.3%) were 8 points. The Visual Analogue Scale (VAS) score and Frankel classification of two group were compared before and after surgery. ResultsSixty-five patients (90.2%) were followed-up with a timespan of 6-12 months (8.5±1.6 months on the average). The VAS score decreased to (2.7±1.2) from preoperatively (5.9±1.1), with statisticl significance (t=21.24, P<0.05). The postoperative Frankel score was significantly improved, with statisticl significance (Z=-4.978, P<0.05). 5 patients among 42 cases with neurological deficit were not improved, 37 cases were partially recovered (Z=-4.978, P<0.05). ConclusionSurgical treatment can relieve the pain and improve the neurological function of patients with spinal metastases of lung cancer.