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目的探讨射频消融术(RFA)联合椎体后凸成形(PKP)治疗脊柱转移癌的临床疗效。方法选取2013年1月至2014年12月间衡水市第四人民医院收治的25例脊柱转移癌患者,采用基本概念视觉模拟评分法(VAS)评估患者术前、术后3天和术后3个月的疼痛感觉,测量患者术前、术后3天和术后3个月侧位X线片上椎体前缘高度。进行手术前后对比,分析RFA联合PKP治疗脊柱转移癌患者的临床疗效。结果患者治疗过程均顺利,其中24例患者术后24h疼痛症状均有缓解。患者腰背部疼痛VAS评分,术前为(8.21±1.38)分,术后3天为(2.26±0.92)分,术后3个月为(0.85±0.43)分。病变椎体前缘高度,术前为(37.87±15.31)mm,术后3天为(19.14±9.47)mm,术后3个月为(22.57±6.73)mm。术后3天和术后3个月患者的VAS评分和病变椎体前缘高度与术前比较,差异均有统计学意义(均P<0.05)。结论 RFA联合PKP治疗脊柱转移癌可显著改善患者生活质量,获得良好的近期效果。
Objective To investigate the clinical effect of radio frequency ablation (RFA) combined with kyphosis (PKP) in the treatment of spinal metastases. Methods From January 2013 to December 2014, 25 patients with metastatic spine of the spine who were admitted to the Fourth People’s Hospital of Hengshui City were enrolled in this study. VAS was used to assess the patients’ preoperative, postoperative 3 days and postoperative 3 Months of pain sensation, measuring the patient before surgery, 3 days after surgery and 3 months after surgery, lateral radiographs of vertebral body anterior height. Before and after operation, the clinical efficacy of RFA combined with PKP in the treatment of patients with spinal metastasis was analyzed. Results The course of treatment was smooth, 24 of which 24 patients had pain relief after 24h. The VAS score of patients with low back pain was (8.21 ± 1.38) minutes before operation, (2.26 ± 0.92) days after operation and (0.85 ± 0.43) points after 3 months. The height of the anterior vertebral body was (37.87 ± 15.31) mm preoperatively, (19.14 ± 9.47) mm on the third postoperative day and (22.57 ± 6.73) mm on the third postoperative month. The VAS score and the anterior vertebral height of the patients at 3 days and 3 months after operation were significantly different from those before operation (all P <0.05). Conclusion RFA combined with PKP in the treatment of spinal metastases can significantly improve the quality of life of patients with good near-term results.