本文關(guān)鍵詞： 骨填充網(wǎng)袋 椎體成形術(shù) 胸腰椎轉(zhuǎn)移瘤 骨水泥滲漏　出處：《中國(guó)脊柱脊髓雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的 :探討應(yīng)用骨填充網(wǎng)袋椎體成形術(shù)治療胸腰椎溶骨性轉(zhuǎn)移瘤的臨床療效。方法 :2012年10月~2016年10月應(yīng)用經(jīng)皮椎體成形術(shù)(percutaneous vertebroplasty,PVP)治療胸腰椎溶骨性轉(zhuǎn)移瘤病例48例,共77個(gè)椎體。其中23例37個(gè)椎體行傳統(tǒng)PVP(傳統(tǒng)PVP組),25例40個(gè)椎體應(yīng)用骨填充網(wǎng)袋(bone filling mesh container,BFMCs)行PVP(BFMCs組),兩組患者年齡、性別比和椎體分布均無(wú)統(tǒng)計(jì)學(xué)差異。術(shù)中在C型臂透視下觀察骨水泥滲漏情況,術(shù)后第3天采用VAS評(píng)分評(píng)估患者疼痛緩解情況、根據(jù)Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)對(duì)活動(dòng)能力改善進(jìn)行評(píng)估,出院前復(fù)查X線、CT觀察受累椎體高度復(fù)位程度。結(jié)果:所有患者均順利完成手術(shù),穿刺成功率為100%,術(shù)中未出現(xiàn)肺栓塞、截癱或圍手術(shù)期死亡。傳統(tǒng)PVP組術(shù)中18個(gè)椎體(48.6%,18/37)出現(xiàn)骨水泥滲漏,但患者均無(wú)骨水泥滲漏的臨床癥狀,BFMCs組術(shù)中無(wú)1例出現(xiàn)骨水泥滲漏。所有患者術(shù)后3d內(nèi)疼痛緩解,傳統(tǒng)PVP組VAS評(píng)分由術(shù)前7.8±1.3分(5~10分)降至2.4±1.4分(1~4分),BFMCs組VAS評(píng)分由術(shù)前7.9±1.1分(6~10分)降至2.5±1.3分(1~4分);ODI傳統(tǒng)PVP組由術(shù)前(73.4±4.6)%降至(23.6±4.3)%,BFMCs組由術(shù)前(74.6±4.9)%降至(23.9±4.5)%。兩組術(shù)后VAS評(píng)分和ODI與術(shù)前比較均有顯著性差異(P0.05),兩組間術(shù)前、術(shù)后比較均無(wú)顯著性差異(P0.05)。術(shù)后病椎前緣和中部高度抬升百分比傳統(tǒng)PVP組分別為(3.2±2.6)%、(5.4±4.1)%,BFMCs組分別為(11.8±11.6)%、(22.1±14.7)%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:對(duì)于胸腰椎溶骨性轉(zhuǎn)移瘤患者應(yīng)用骨填充網(wǎng)袋行PVP可明顯降低骨水泥椎體外滲漏率,更好地恢復(fù)椎體高度,在疼痛緩解與活動(dòng)能力改善方面與傳統(tǒng)PVP相似。
[Abstract]:Objective: To evaluate the clinical application of bone filling bag vertebroplasty for thoracolumbar vertebral osteolytic metastases. Methods: October 2012 ~2016 year in October the application of percutaneous vertebroplasty (percutaneous, vertebroplasty, PVP) solution for the treatment of thoracolumbar metastatic tumors and 48 patients with a total of 77 cases of osteoarthritis, 23 cases of vertebral body. 37 vertebrae underwent conventional PVP (PVP group), 25 patients with 40 vertebral bone filling bag (bone filling mesh container, BFMCs) PVP (BFMCs group), two groups of patients with age, sex ratio and body distribution were not statistically significant. In the operation of C arm fluoroscopy observation of bone cement leakage, third days after surgery using VAS score to evaluate the pain relief, according to the Oswestry disability index (Oswestry disability index, ODI) for activity improvement was assessed before X-ray discharge, CT observation of vertebral height reduction involvement degree. Results: all patients were successfully 鍒╁畬鎴愭墜鏈，

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