[1]侯明远,王志龙,姜方舟,等.CT引导下微波消融联合椎体成形术治疗脊柱转移瘤疗效及骨水泥渗漏危险因素分析[J].介入放射学杂志,2025,34(02):186-191.
　HOU Mingyuan,WANG Zhilong,JIANG Fangzhou,et al.The curative effect of CT-guided microwave ablation combined with percutaneous vertebroplasty for spinal metastases and the analysis of risk factors for bone cement leakage[J].journal interventional radiology,2025,34(02):186-191.
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CT引导下微波消融联合椎体成形术治疗脊柱转移瘤疗效及骨水泥渗漏危险因素分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年02
页码:
186-191
栏目:
临床研究
出版日期:
2025-02-17

文章信息/Info

Title:
The curative effect of CT-guided microwave ablation combined with percutaneous vertebroplasty for spinal metastases and the analysis of risk factors for bone cement leakage
作者:
侯明远; 王志龙; 姜方舟; 王泽锐; 梁逸宁; 李一兵; 左太阳
Author(s):
HOU Mingyuan; WANG Zhilong; JIANG Fangzhou; WANG Zerui; LIANG Yining; LI Yibing; ZUO Taiyang.
School of Medical Imaging，Shandong Second Medical University，Weifang，Shandong Province 261053，China
关键词:
【关键词】微波消融; 经皮椎体成形术; 脊柱转移瘤; 疗效; 骨水泥渗漏; 危险因素
文献标志码:
A
摘要:
【摘要】目的探讨CT引导下微波消融（MWA）联合经皮椎体成形术（PVP）治疗脊柱转移瘤的近期疗效并分析术后发生骨水泥渗漏的危险因素。方法回顾性分析2020年1月至2023年6月山东第一医科大学附属中心医院应用CT引导下MWA联合PVP治疗脊柱转移瘤50例74节椎体，采用疼痛数字评定量表评分（NRS）、吗啡日消耗量（DMC）和日常生活能力量表评分（ADL）评价近期临床疗效，术后CT定期复查评价局部肿瘤控制及骨水泥渗漏情况。纳入性别、年龄、脊柱转移瘤的最大径、转移瘤类型、原发癌Tomita分类、受累椎体水平、骨水泥注射量、注射侧向、病理性骨折和椎体后壁破裂等，采用单因素和多因素二元logistic分析评估术后发生骨水泥渗漏的危险因素。结果术前、术后1天、1周和1、3、6个月随访NRS分别为（7.24±1.41）、（4.76±1.45）、（3.42±1.34）、（2.86±0.90）、（2.20±0.57）、（1.66±0.72）分；术前、术后1天、1周和1、3、6个月随访DMC分别为（110.40±94.61）、（66.10±51.23）、（47.30±37.49）、（32.90±22.84）、（25.60±18.97）、（15.36±13.43）mg；术前、术后1周和1、3、6个月ADL分别为（40.80±11.45）、（53.20±6.68）、（60.40±5.14）、（62.90±4.75）、（64.80±4.51）分。术前及术后6个月内随访NRS、DMC、ADL的差异有统计学意义（P＜0.05）。术后6个月影像检查随访，有46例患者肿瘤得到控制，局部肿瘤复发率为8%（4/50）。在74节椎体中有17（22.97%）节椎体发生轻度骨水泥渗漏。多因素logistic分析显示病理性骨折（OR=9.581，95%CI=2.292～40.055，P=0.002）及椎体后壁破裂（OR=5.105，95%CI=1.041～25.022，P=0.044）是骨水泥渗漏的独立危险因素，病理性骨折（OR=35.333，95%CI=4.029～309.840，P=0.001）是皮质骨水泥渗漏的独立危险因素，未发现血管骨水泥渗漏的独立危险因素，椎体后壁破裂（OR=48.400，95%CI=4.725～495.753，P=0.001）是椎管内骨水泥渗漏的独立危险因素。结论MWA联合PVP治疗脊柱转移瘤能快速缓解患者疼痛，提高日常活动能力和生活质量，术后6个月内呈进一步改善趋势；联合治疗骨水泥渗漏发生率低，病理性骨折及椎体后壁破裂是骨水泥渗漏的独立危险因素。

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备注/Memo

备注/Memo:
（收稿日期：2024-03-04）
（本文编辑：茹实）
更新日期/Last Update: 2025-02-17