| 陈珑,倪才方,刘一之,杨惠林,唐天驷,金泳海,朱晓黎,邹建伟,丁乙.经皮椎体成形术治疗椎体良恶性病变[J].中国医学影像技术,2006,22(7):1070~1073 |
| 经皮椎体成形术治疗椎体良恶性病变 |
| Percutaneous vertebroplasty for benign and malignant vertebral diseases |
| 投稿时间：2005-12-16 修订日期：2006-05-12 |
| DOI： |
| 中文关键词: 脊柱疾病 聚甲基丙烯酸类 放射学,介入性 |
| 英文关键词:Spinal diseases Polymethacrylic acids Radiology, interventional |
| 基金项目:江苏省"135"工程重点人才基金(RC2003097)。 |
|
| 摘要点击次数: 1992 |
| 全文下载次数: 880 |
| 中文摘要: |
| 目的 研究经皮椎体成形术的关键技术及临床疗效。方法 应用经皮椎体成形术治疗44例57个椎体,其中骨质疏松性椎体压缩骨折12例13个椎体,肿瘤性病变32例44个椎体。注射骨水泥前先行椎体内静脉造影,然后于透视监控下注入骨水泥。记录患者术前、术后24 h、术后1周、术后1个月的疼痛视觉模拟划线得分(VAS)。观察止痛效果和并发症。结果 57个椎体成功行经皮椎体成形术。骨折患者每个椎体平均注入骨水泥(5.2±1.3) ml,而肿瘤患者为(5.1±1.2) ml,两者间无统计学差异(P>0.05)。1个月后患者疼痛缓解的总有效率为93.2%(41/44)。患者术前与术后24 h、术后1周、术后1个月的VAS的得分之间存在统计学差异(P＜0.05)。骨折患者术后1个月的VAS得分(1.7±0.7)小于肿瘤患者(2.6±1.4)(P＜0.05)。所有病例术后无1例椎体塌陷加重或发生新的骨折。除10个椎体发生无症状的骨水泥渗漏外,无1例发生严重并发症。结论 经皮椎体成形术能有效加固病变椎体,止痛效果满意。手术疗效与骨水泥的用量无关而与病变性质有关:对骨折患者的止痛效果优于肿瘤患者。合理使用穿刺技术,注射骨水泥前行椎体内静脉造影、掌握骨水泥的注射时机并于透视监控下注射骨水泥是预防并发症及提高手术成功率的关键。 |
| 英文摘要: |
| Objective To study the key technique and therapeutic effect of percutaneous vertebroplasty (PVP). Methods Forty-four patients with 57 vertebrae underwent PVP, including 13 osteoporotic vertebral compression fractures (VCFs) in 12 cases and 44 vertebral tumors in 32 cases. Intraosseous venography was performed followed by injecting bone cement under the fluoroscopy. The score of visual analogue scale point (VAS) (10-point scale) before vertebroplasty, 24 hours, one week and one month after vertebroplasty was recorded respectively. Result of pain relief and complications were observed. Results The procedure was technically successful in all patients. The amount of bone cement injected in each vertebra of patients with VCFs was in average (5.2±1.3) ml, while in patients with vertebral tumors was (5.1±1.2) ml. There was no significant difference between the two groups (P>0.05). The overall rate of pain relief was 93.2% after 30 days of the operation. There are significant differences among the score of VAS with different time points (P＜0.05). The score of VAS after vertebroplasty in patients with VCFs was lower than patients with tumors (P＜0.05). No further or new vertebral compression occurred in all patients during the follow-up of 1-12 months. No major complications occurred in this series, except asymptoamic bone cement leaking around vertebrae. Conclusion PVP could provide significant pain reduction and vertebral strengthening in the treatment of patient with different vertebral disease. The effect of pain relief was not related to the amount of bone cement injected. Patients with osteoporotic VCFs have better therapeutic effect than patients with vertebral tumors. Adopting proper puncture technique, using pretreatment intraosseous venography and injecting bone cement reasonably under fluoroscopy were the key techniques to improve success rate of operation and prevent complications of PVP. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
