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CT引导下经皮穿刺椎体成形术应用研究 被引量:19

The clinic study of percutaneous vertebroplasty by CT guidance
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摘要 目的:观察经皮穿刺椎体成形术(PVP)在良、恶性椎体病变中的疗效、并发症及随访结果,探讨相关机理。方法:在CT定位下PVP治疗患者86例,采用疼痛调查表进行疗效评估,定期随访及影像学复查。结果:良性病变94.7%有效且长期效果稳定。转移瘤87.7%有效且3个月不变,4~6个月降到75.4%。发现19.8%有新骨形成或重新骨化现象。并发症少,轻微且易于处理。结论:PVP治疗椎体溶骨性或钙缺失性病变疗效好且稳定,良性优于恶性。PVP有抑制肿瘤生长及促进骨生成作用,机理复杂可能是多种因素综合作用的结果。PVP适用范围广、操作简单、疗效确实、不良反应少,可进一步推广应用。 Objective:To determine the efficacy of percutaneous vertebroplasty(PVP)in treating benign or malignant spinal lesions that result in pain and instability.Methods:Eighty-six patients(male67,female19,aged31~70years)underwent 117percutaneous injections of bone cement into vertebra under CT guidance.Results:The effective rate of benign lesions was94.7%,and the lesions were stable until today.The effective rate of malignant lesions was87.7%and were stable in the first three months,the effective rate reduced to75.4%in4to6months.Osteogenesis or ossification was observed in19.8%of le-sions that were treated by PVP.Conclusion:The curative effect of PVP which was used to treat osteolytic or calciprivic le-sions is better and stable.The curative effect of PVP in benign lesions is better than malignant.PVP have the effect to inhibit tumor growth and promote ossification.The mechanism of PVP is complex,its effects result from many factors.The advan-tages of PVP are wide application,simple-operation,reliable effect and only few complications.It can be widely applied.
出处 《中国临床医学影像杂志》 CAS 2002年第1期45-49,共5页 Journal of China Clinic Medical Imaging
基金 陕西省自然科学基金资助项目(编号:98SM41)
关键词 X线计算机体层摄影术 经皮穿刺椎体成形术 疗效 并发症 椎体康复 PVP 良性肿瘤 恶性肿瘤 percutaneous vertebroplasty tomography,X-ray computed
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参考文献8

  • 1Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochiruigie, 1987, 33 (2): 166-168.
  • 2Dousset V, Mousselard H, de Monck L, et al. Asymptomatic cervical heamangioma treated by percutaneous vertebroplasyNeuroradiology, 1996, 38 (4): 392-394.
  • 3Goltra JR. Vertebroplasty for osteoporotic compression fractures: effective treatment for a neglected disease. AJNR, 2001,22 (3): 594-595.
  • 4Deramond H, Depriester C, Galibert P, et al. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. R adiol Clin North Am, 1998, 36 (3): 533-546.
  • 5Hass SS, Brauer GM, Dickon G, et al. A characterization of polymethylmethacrylate bone cement. J Bone Joint Surg, 1975,57 (3): 380-391.
  • 6Deramond H, Wright NT, Belkoff SM. Temperature elevation caused by bone cement polymerization during vertebroplasty.Bone, 1999, 25 (2 Suppl): 17S-21S.
  • 7陆军,张贵祥,赵海涛.经皮穿刺椎体成形术的影像学研究[J].中国医学影像学杂志,2001,9(4):244-246. 被引量:34
  • 8Padovani B, Kasriel O, Brunner P, et al. Pulmonary embolism caused by acrylic cement: a rare complication of percuta-neous vertebroplasty. AJNR, 1999, 20 (3): 375-377.

二级参考文献7

  • 1[1]Dousset V, Mousselard H, Bouvet R, et al. Asymptomatic cervical haemangiomas treated by percutaneous vertebroplasty. Neuroradiology 1996, 38(4):392
  • 2[2]Jensen ME, Evans A J, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 1997, 18(10): 1897
  • 3[3]Weill A, Chiras J, Simon JM, et al. Spinal metastases: indications for and of percutaneous injection of acrylic surgical cement. Radiology 1996, 199(1):241
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  • 5[5]Cortet B, Cotton A, Boutry N et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 1999, 26( 10)2222
  • 6[6]Cotton A, Dewatre F, Cortet B, et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methalcrylate at clinical follow-up. Radiology 1996,200(2) :525
  • 7[7]Deramond H, Dpriester C, Galibert P, et al. Percutaneous vertebroplasty with methyl-methacrylate: technique, method, results. Radiol Clin North Am 1998, 36(3) :533

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