经皮椎体成形术联合奥施康定治疗椎体转移性癌痛的临床研究

目的:观察经皮椎体成形术(PVP)联合奥施康定治疗椎体转移性癌痛的临床疗效及安全性。方法:共纳入我院收治的96例椎体转移性癌痛患者。根据患者疼痛评分行奥施康定滴定止痛治疗;严格掌握PVP手术适应证,符合患者行手术治疗;评价用药后患者止痛疗效、止痛药物使用情况、生活质量改善情况及不良反应情况。结果:经给予奥施康定止痛治疗后,患者疼痛得到缓解;联合PVP治疗后,所有患者奥施康定总量下降32.2%,其中减量75%以上有7人,减量>50%~75%有13人,减量25%~50%有42人,减量<25%有31人,原剂量有3人,无人增量。治疗前KPS评分为(64.69±5.07)分,奥施康定治疗后KPS评分为(71.56±7.67)分,联合治疗后KPS评分为(77.19±8.10)分;治疗不良反应主要为骨水泥渗漏、治疗部位一过性胀痛、消化道症状及嗜睡等。结论:经皮椎体成形术联合奥施康定治疗椎体转移癌痛具有较好的临床疗效和安全性,值得临床推广使用。

Clinical study of percutaneous vertebroplasty combined with oxycodone in the treatment for vertebral metastases cancer pain patients

Objective:To investigate the clinical efficacy and safety of percutaneous vertebroplasty(PVP)combined with oxycodone in the treatment for vertebral metastases cancer pain patients.Methods:96 patients with vertebral metastases cancer pain were admitted to our hospital.According to the pain score，the patients were treated with oxycodone.The patients were treated with the operation，who satisfied the operation indications of PVP.The relief of pain，the dosage of analgesics，the improvement of quality of life and the side effects were evaluated.Results:After giving oxycodone，the pain of patients was relieved.After combining with PVP treatment，the dosage of oxycodone decreased by 32.2%.7 patients decreased the dosage more than 75%.13 patients decreased dosage between ＞50% and 75%.42 patients decreased dosage between 25% and 50%.31 patients decreased dosage less than 25%.3 patients kept same dosage，and no one increased the dosage.Before treatment，the KPS score was （64.69±5.07） scores.After oxycodone treatment，the KPS score was （71.56±7.67）scores and combined treatment was (77.19±8.10)scores，respectively.The main side effects had bone cement leakage，temporary swelling and pain at the site of treatment，digestive symptoms and sleepiness.Conclusion:Percutaneous vertebroplasty combined with oxycodone has good clinical efficacy and safety in the treatment of vertebral metastatic cancer pain，which is worthy of clinical application.