18例椎体转移癌的联合介入治疗临床观察

目的探讨经皮穿刺椎体成形术联合肿瘤供血动脉化疗栓塞术联合介入治疗方法治疗椎体转移癌的临床应用价值。方法选择18例椎体转移癌患者,先采用经皮经椎弓根穿刺被破坏椎体注射骨水泥,术后一周左右再采用Seldinger穿刺插管技术,选取适当化疗药物、碘油或明胶海绵行肿瘤供血动脉化疗栓塞术,并作相关临床观察。结果血管性介入治疗四周后,作疗效评价。治疗前后分别为疼痛（VRS分级）：15例疼痛程度降低1级或以上,有效率83.3%;生存质量（中国1990年制定）评价：14例生存质量提高1级或以上,有效率77.8%;疗效评价（RECIST方法）：CR0例（0%）、PR4例（22.2%）、SD9例（50.0%）、PD5例（27.8%）,有效率22.2%。不良反应可控制。结论对部分椎体转移癌患者,作经皮穿刺椎体成形术,术后一周左右再行肿瘤供血动脉化疗栓塞术具有安全、高效的特点,且相互间有协同作用,值得推广使用。临床中,该类病人不可轻易放弃治疗。

Clinical Observation of curative effect of combination interventional therapy to treat vertebral metastatic carcinoma

Objective To evaluate the curative effect of percutaneous vertebroplasty combined with transcatheter arterial chemoembolization therapy in treating vertebral metastases. Methods 18 cases with vertebral metastatic carcinoma were chosen. The vertebral body was percutaneously punctured to inject bone cement. About a week later,the TACE was done with appropriate chemotherapy,lipiodol or gelatin sponge. The patients were followed up. Results Evaluation was done four weeks after interventional treatment. Pain was...