经皮椎体成形术联合125I放射粒子植入术治疗椎体转移瘤的效果评价

目的：探讨经皮椎体成形术（PVP）联合¹²⁵I放射性粒子植入术治疗椎体转移瘤患者的临床疗效，为治疗椎体转移瘤提供依据。方法：69例椎体转移瘤患者分为试验组（n=32）和对照组（n=37），试验组患者采用PVP联合¹²⁵I放射性粒子植入术治疗，对照组患者单独采用PVP手术治疗。X射线片检查治疗前后患者椎体前后缘高度；观察并记录患者术前和术后1天、1周、1个月、3个月、6个月的疼痛数字评分（NRS），比较2组患者疼痛缓解率和手术并发症发生率。结果：所有患者手术过程顺利，术后未发现局部出血，未造成运动功能障碍及神经压迫现象。术后次日复查未发现骨水泥外漏现象。所有¹²⁵I放射性粒子位置良好，未见脱落。治疗后2组患者椎体高度较治疗前升高（P<0.05）。与术前比较，2组患者术后1天、1周、1个月、3个月和6个月NRS评分均明显降低（P < 0.05）；在术后1周、1个月、3个月、6个月，试验组患者NRS评分低于对照组（P < 0.05）。69例患者中肺栓塞或放射性脊髓炎等手术并发症（3例）发生率为4.3%，2组患者手术并发症发生率比较差异无统计学意义（P < 0.05）。结论：PVP联合¹²⁵I粒子植入术治疗椎体转移瘤是一种安全有效的方法，与单独采用PVP手术治疗比较，其可以更明显地缓解患者的疼痛。

Effectiveness evaluation on percutaneous vertebroplasty combined with 125 I radioactive particle implantation in treatment of vertebral metastasis

Objective: To evaluate the clinical effect of pereutaneous vertbroplasty (PVP) combined with implantation of iodine-125 (125 I)radioactive particle in the treatment of vertebral metastasis,and to provide basis for the treatment of vertebral metastasis.Methods:A total of 69 patients with vertebral metastasis were divided into test group (n=32)and control group (n=37);the patients in test group were treated with PVP comined with implantation 125 I radioactive particle and the patients in control group were treated with PVP only.The heights of anterior and posterior vertebral bodies of the patients before and after treatment were detected by X-ray.The numerical rating scale (NRS)scores,pain relief rate and the incidence of surgical complications of the patients were recorded before operation and 1 d,1 week,1 month,3 months,and 6 months after operation.Results:The operation was successfully performed in all the patients without local bleeding;there were no movement dysfunction and nerve compression phenomenon.There was no leakage of bone cement.All the 125 I radioactive particles located well and there was no particle obscission.The heights of vertebral bodies of the patients in two groups after operation were increased compared with before operation (P <0.05).The NRS scores of the patients in two groups s at 1 d,1 week,1 month,3 months,6 months after operation were significantly decreased compared with before operation (P <0.05);compared with control group,the NRS scores of the patients in test group at 1 d,1 week, 1 month,3 months,6 months after operation were decreased (P <0.05).The incidence of pulmonary embolism or radiation myelitis complications was about 4.3% in 69 patients.Compared with control group,the difference in the incidence of complications of the patients in test group was not significant (P < 0.05 ).Conclusion:PVP combined with 125 I radioactive particle implantation is a safe and effective method in the treatment of vertebral metastasis,which can relieve the pain of the patients obviously compared with PVP.