摘要
目的 应用国产药械行椎体成形术治疗椎体良恶性病变 ,观察其疗效 ,探讨椎体成形术操作技术。方法 5 7例 89个病变椎体行经皮椎体成形术 ,术中应用国产药械。经前、后外侧入路、椎弓根入路行椎体成形术 ,操作在X线透视或CT监测下进行 ,国产PMMA粉、液及对比剂比例为 3∶2∶1。手术前后CT检查对照。骨质疏松性椎体压缩骨折和血管瘤患者随访 5～ 2 4个月 ,转移瘤患者随访 7～ 12个月 ,观察临床疗效。结果 穿刺成功率 10 0 %,术后CT检查显示PMMA填充病灶均在 5 0 %以上。 2 2例骨质疏松性椎体压缩骨折与血管瘤组术后 3d内患者的治疗效果为 :CR 19例 ,PR 3例 ,临床治疗有效率达 10 0 %。随访 5～ 2 4个月 ,未发现注射PMMA的椎体有新压缩出现 ;转移瘤组 91.4%(32 / 35 )的患者术后 7d内症状明显缓解 ,止痛效果在 6个月内为 74.3%(2 6 / 35 ) ,1年内为 5 6 .3%(18/ 32 )。未发生由于PMMA外溢出现的临床症状并发症。结论 应用国产药械行椎体成形术治疗椎体良恶性病变效果良好。
Objective To evaluate the treating effect of percutaeous vertebroplasty using instruments made in China for benign and malignant vertebral lesions and to explore the technique of percutaneous vertebroplasty.Methods 57 cases with 89 vertebral lesions underwent PVP. PVP were performed with instruments made in China. Anterolateral route for cervical spine and transpedicular route for thoracic and lumbar spine were taken under the guidance of fluoroscopy. Postlateral route for cervical spine under the guidance of CT. Mixture of PMMA with contrast medium was made according to the ratio of powder/liquid/contrast as 3∶2∶1 in injecting paste form. CT scan were performed before and after the procedure. Results Successful rate of PVP reached 100%. The percentage of lesion PMMA fill was more than 50% demonstrated by CT. The clinical follow-up of the vertebral osteoporotic fractures in 17 cases and that of hemangiomas in 5 cases were up to 5-24 monthes CR and PR were achieved in 19 cases and 3 cases respectively after 3 days of the procedure without new collapse further in 22 cases. Thirty five cases with vertebral metastatic neoplasms were followed up for 7-12 months. The rates of obvious pain relief were 91.4%(32/35) in 7 days, 74.3%(26/35) in 6 months, 56.3%(18/32) in 12 months after the procedure. No leaks of PMMA and correlated complication had occurred. Conclusions The clinical effect of percutaneous vertebroplasty using instruments made in China for benign and malignant vertebral lesions is safe and satisfactory.
出处
《介入放射学杂志》
CSCD
2003年第4期276-279,共4页
Journal of Interventional Radiology
基金
济南军区重点研究项目 (编号 :0 2z76)
