PVP术治疗胸腰椎转移癌的临床疗效观察

目的 探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)对治疗胸腰椎转移癌患者的疗效.方法 随机选取31例胸腰椎转移癌患者,共97个椎体.PVP治疗组16例,椎体50个;对照组传统治疗15例,椎体47个.疼痛缓解度用视觉模拟评分(VAS),生活质量用生活自理能力评估(ADL).术中PVP组患者椎体注入骨水泥,在术后1天、3天、3个月、6个月利用VAS、ADL评估经PVP术治疗胸腰椎转移癌患者的临床效果.结果 PVP组术后1天VAS评分由最初的(7.35±1.67)下降到(2.61±1.07),术后3天、3个月、6个月患者VAS评分均有明显的下降.对照组患者术后1天VAS评分由最初的(7.32±1.64)下降为(5.19±1.36),术后3天、3个月、6个月患者VAS评分也有所下降,但不如PVP组明显,2组VAS评分数据间差异具有统计学意义(P<0.05).PVP组治疗后生活质量ADL评分(15.28±2.69)明显高于治疗前ADL评分(9.56±1.79);对照组治疗后ADL评分(11.87±3.11)明显高于术前ADL评分(9.02±3.04),P均<0.05.组间比较PVP组生活质量ADL显著高于对照组,P<0.05.结论 骨水泥在病椎的充盈情况对患者的疼痛度有至关重要的影响,在治疗胸腰椎转移癌患者时,采用PVP形成术能较大程度上缓解患者的疼痛,提高患者生活质量.

Clinical Efficacy of PVP for Thoracolumbar Metastatic Cancer

Objective To investigate the effect of percutaneous vertebroplasty ( PVP) in the treatment of thoracic and lumbar metastatic carcinoma .Methods A total of 97 cases of vertebral bodies were randomly selected from 31 patients with me-tastatic carcinoma of the thoracic and lumbar spine .PVP treatment group of 16 cases,50 vertebral bodies;the control group,15 ca-ses of traditional treatment,47 vertebral body.Visual analogue scale (VAS) for pain relief,quality of life (ADL).PVP group of patients with vertebral bone cement ,1 days,3 days,3 months,6 months after,the use of VAS,ADL to assess the clinical effect of PVP surgery for patients with thoracic and lumbar metastatic cancer .Results The VAS score of PVP group decreased from (7.35 ±1.67)to (2.61 ±1.07),and the VAS score decreased significantly at 3 days,3 months and 6 months after operation.In the control group,the VAS score was calculated from (7.32 ±1.64) to (5.19 ±1.36)(P<0.05).The VAS score of the 2 groups was significantly lower than that of the PVP group (P<0.05).The difference between the 2groups was statistically signifi-cant (P<0.05).The ADL score (11.87 ±3.11) in the control group was significantly higher than that in the preoperative ADL score (9.02 ±3.04) and P<0.05.The ADL score (15.28 ±2.69) was significantly higher than that of the ADL before treat-ment (9.56 ±1.79) The quality of life of PVP group was significantly higher than that of the control group (P<0.05).Conclu-sion The filling of the bone cement in the vertebral directly affect the pain in patients ,percutaneous vertebroplasty ( PVP) has the advantage of a greater degree of patient can relieve pain ,help improve the life of patients .