氩氦刀或唑来膦酸单用及联合应用治疗骨转移癌疼痛对照研究

目的比较氩氦刀或唑来膦酸单一治疗和联合治疗骨转移癌疼痛的疗效和安全性。方法 84例患者随机分为A组(联合)、B组(氩氦刀)、C组(唑来膦酸)各28例;A组氩氦刀冷冻消融治疗结束后给予唑来膦酸注射液4 mg加入0.9%氯化钠注射液100 ml静脉滴注15 min以上;B组单一使用氩氦刀冷冻消融骨转移癌局部组织;C组给子唑来膦酸注射液4 mg加入0.9%氯化钠注射液100 ml静脉滴注15 min以上。结果①A组止痛总有效率为85.7%,其中显效为35.7%(10/28),有效为50.0%(14/28);B组止痛总有效率为50.0%,其中显效为14.3%(4/28),有效为35.7%(10/28),C组总有效率为67.9%(19/28),其中显效为21.4%(6/28),有效为46.4%(13/28),3组间比较差异有统计学意义(P<0.05)。②平均起效时间:A组为(1.96±2.26)d,B组为(1.43±1.79)d,C组为(11.67±3.14)d,A、B两组与C组之间差异有统计学意义(P<0.05)。③疗效维持时间:A组为(146.68±1.89)d,B组为(71.60±2.94)d,C组为(112.99±1.37)d,3组间比较差异有统计学意义(P<0.01)。结论氩氦刀冷冻消融联合唑来膦酸治疗骨转移癌性疼痛是一种安全、有效的技术。

Separate use or combined use of cryoablation and zoledronic acid for the treatment of pain caused by bone metastases: a comparative study

Objective To compare the efficacy and safety of separate use or combined use of cryoablation and zoledronic acid in treating the pain caused by bone metastases.Methods A total of 84 patients were randomly and equally divided into three groups with 28 patients in each group.Combination use of cryoablation and zoledronic acid was carried out in patients of group A.The cryoablation catheter ablation was performed first,which was followed by intravenous dripping of zoledronic acid(4mg added in 100 ml normal saline),and the dripping lasted for more than 15 min.For patients in group B,only cryoablation catheter ablation was used for local bone metastases,and only intravenous dripping of zoledronic acid(4mg added in 100 ml normal saline) was given to patients in group C.The clinical results were analyzed and compared among the three groups.Results①For group A,the total anti-pain effect rate was 85.7%, including excellent rate 35.7%(10/28) and effective rate 50.0%(14/28).For group B,the total anti-pain effect rate was 50.0%,including excellent rate 14.3%(4/28) and effective rate 35.7%(10/28).For group C, the total anti-pain effect rate was 67.9%,including excellent rate 21.4%(6/28) and effective rate 46.4% (13/28).The differences among the three groups were statistically significant(P < 0.05).②The mean time to respond in group A,B and C was(1.96±2.26) days,(1.43±1.79) days and(11.67±3.14) days,respectively.The differences between group A and group C as well as between group B and group C were statistically significant(P < 0.05).③The duration of maintaining curative effect in group A,B and C was(146.68±1.89) days,(71.60±2.94) days and(112.99±1.37) days,respectively.The differences among the three groups were statistically significant(P < 0.01).Conclusion Cryoablation ablation combined with intravenous dripping of zoledronic acid is a safe and effective therapy for the treatment of the pain caused by bone metastases.