CT Guided Percutaneous Osteoplasty of Ilium to Treat Metastatic Tumor of Ilium_West China Medical Journal

Authors：

Department of Oncology, West China Hospital, Chengdu, Sichuan 610041, P. R. China;

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Keywords：

骨水泥; 髂骨; 惡性腫瘤; 骨成形術; 轉移瘤

DOI：

10.7507/1002-0179.20130224

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目的　探討CT引導下髂骨成形術在治療惡性腫瘤晚期髂骨轉移中的價值。方法　對2009年3月－2011年8月收治的12例經病理活檢證實為惡性腫瘤髂骨轉移患者共，分別行CT引導下骨水泥注入髂骨成形術并觀察該組患者治療后的疼痛緩解、生活質量改善及生存期等。結果　該組患者手術后24 h內，疼痛與術前相比差異無統計學意義（t=2.433，P＞0.05），手術后3 d和7 d進行再次評估，與治療前相比差異有統計學意義（t=3.123，3.124；P＜0.05）；術后該組患者在軀體功能、心理功能、社會功能、物質生活狀態方面的生活質量評分顯著高于手術前（t=2.341，2.354，3.567，3.124；P＜0.05）。該組總有效率為82.5%。且治療后癌胚抗原（CEA）含量為（2.9 ± 0.9）μg/L，顯著低于治療前的（15.5 ± 3.2）μg/L（P＜0.01）。所有患者隨訪1年，其6、10、12個月的總生存率分別為15.2%、32.8%、52.0%，平均生存時間10.4個月。該組患者治療后并發癥情況發生率58.3%，均為出現了無癥狀的骨水泥滲漏現象，注射治療后持續時間為0.5～3 h，平均1.87 h。結論　髂骨成形術短期內可明顯減輕惡性腫瘤髂骨轉移所致的疼痛癥狀。CT引導下髂骨成形術安全、可靠、近期療效確切，是姑息性治療惡性腫瘤髂骨轉移的有效方法之一。

Citation： YOU Xin,TENG Haoqi,LIAO Zhengyin,PU Ji.. CT Guided Percutaneous Osteoplasty of Ilium to Treat Metastatic Tumor of Ilium. West China Medical Journal, 2013, 28(5): 719-723. doi: 10.7507/1002-0179.20130224 Copy

1.	鄧鋼, 何仕誠, 滕皋軍, 等. 經皮椎體成形術治療脊椎惡性腫瘤[J]. 介入放射學雜志, 2005, 14(3): 261-265.
2.	Weill A, Chiras J, Simon JM, et al. Spinal matastases:indications for and results of Percutaneaous injection of acrylic surgical cement[J]. Radiology, 1996, 19(02): 241-247.
3.	Kelekis A, Lovblad KO, Mehdizade A, et al. Pelvic osteoplasty in osteolytic metastases: technical approach under fluoroscopic guidance and early clinical results[J]. J Vasc Interv Radiol, 2005, 16(1): 81-83.
4.	Masala S, Konda D, Massari F, et al. Sacroplasty and iliac osteoplasty under combined CT and fluoroscopic guidance[J]. Spine (Phila Pa 1976), 2006, 31(18): 667-669.
5.	李泉旺, 胡凱文, 姜敏, 等. CT引導經皮穿刺骨成形術在惡性腫瘤骨破壞治療中的應用[J]. 臨床腫瘤學雜志, 2010, 8(15): 745-748.
6.	Christoph Trumm, Tobias Jakobs, Anne Pahl, et al. CT fluoroscopy-guided percutaneous vertebroplasty in patients with multiple myeloma: analysis of technical results from 44 sessions with 67 vertebrae treated[J]. Diagn Interv Radiol, 2012, 18(1): 111-120.
7.	Strub WM, Hoffmann M, Ernst RJ, et al. Sacroplasty by CT and fluoroscopic guidance: is the procedure right for your patient? [J]. AJNR Am J Neuroradiol, 2007, 28(1): 38-41.
8.	Kobayashi T, Arai Y, Takeuchi Y, et al. Phase I/II clinical study of percutaneous vertebroplasty (PVP) as palliation for painful malignant vertebral compression fractures (PMVCF): JIVROSG-0202[J]. Ann Oncol, 2009, 20(12): 1943-1947.
9.	張戰利, 張炎, 張俊玲, 等. 經皮椎體成形術治療椎體惡性病變的臨床應用[J]. 實用放射學雜志, 2005, 12(02): 78-79.
10.	Nizar A, Al-Nakshabandi. Percutaneous vertebroplasty complications[J]. Ann Saudi Med, 2011, 31(3): 294-297.
11.	Nelson DW, Duwelius PJ. CT guided fixation of sacral fractures and sacro iliac disruptions[J]. Radiology, 1991, 180(2): 527-532.
12.	薛波. CT引導下空心拉力螺釘內固定治療復合體損傷[J]. 骨與關節損傷雜志, 2009, 12(08): 723-724.
13.	王爭明, 陳新．多層螺旋CT在經皮穿刺肺組織活檢中的應用價值[J]. 臨床放射學雜志, 2008, 27(8): 1038-1041.
14.	李盛祥, 鞏湘浩, 曹火乃．CT引導下經皮肺穿刺活檢對肺部小病灶(≤3 cm)的診斷價值[J].南華大學學報·醫學版, 2008, 36(4): 473-475．.

1. 　鄧鋼, 何仕誠, 滕皋軍, 等. 經皮椎體成形術治療脊椎惡性腫瘤[J]. 介入放射學雜志, 2005, 14(3): 261-265.
2. 　Weill A, Chiras J, Simon JM, et al. Spinal matastases:indications for and results of Percutaneaous injection of acrylic surgical cement[J]. Radiology, 1996, 19(02): 241-247.
3. 　Kelekis A, Lovblad KO, Mehdizade A, et al. Pelvic osteoplasty in osteolytic metastases: technical approach under fluoroscopic guidance and early clinical results[J]. J Vasc Interv Radiol, 2005, 16(1): 81-83.
4. 　Masala S, Konda D, Massari F, et al. Sacroplasty and iliac osteoplasty under combined CT and fluoroscopic guidance[J]. Spine (Phila Pa 1976), 2006, 31(18): 667-669.
5. 　李泉旺, 胡凱文, 姜敏, 等. CT引導經皮穿刺骨成形術在惡性腫瘤骨破壞治療中的應用[J]. 臨床腫瘤學雜志, 2010, 8(15): 745-748.
6. 　Christoph Trumm, Tobias Jakobs, Anne Pahl, et al. CT fluoroscopy-guided percutaneous vertebroplasty in patients with multiple myeloma: analysis of technical results from 44 sessions with 67 vertebrae treated[J]. Diagn Interv Radiol, 2012, 18(1): 111-120.
7. 　Strub WM, Hoffmann M, Ernst RJ, et al. Sacroplasty by CT and fluoroscopic guidance: is the procedure right for your patient? [J]. AJNR Am J Neuroradiol, 2007, 28(1): 38-41.
8. 　Kobayashi T, Arai Y, Takeuchi Y, et al. Phase I/II clinical study of percutaneous vertebroplasty (PVP) as palliation for painful malignant vertebral compression fractures (PMVCF): JIVROSG-0202[J]. Ann Oncol, 2009, 20(12): 1943-1947.
9. 　張戰利, 張炎, 張俊玲, 等. 經皮椎體成形術治療椎體惡性病變的臨床應用[J]. 實用放射學雜志, 2005, 12(02): 78-79.
10. 　Nizar A, Al-Nakshabandi. Percutaneous vertebroplasty complications[J]. Ann Saudi Med, 2011, 31(3): 294-297.
11. 　Nelson DW, Duwelius PJ. CT guided fixation of sacral fractures and sacro iliac disruptions[J]. Radiology, 1991, 180(2): 527-532.
12. 　薛波. CT引導下空心拉力螺釘內固定治療復合體損傷[J]. 骨與關節損傷雜志, 2009, 12(08): 723-724.
13. 　王爭明, 陳新．多層螺旋CT在經皮穿刺肺組織活檢中的應用價值[J]. 臨床放射學雜志, 2008, 27(8): 1038-1041.
14. 　李盛祥, 鞏湘浩, 曹火乃．CT引導下經皮肺穿刺活檢對肺部小病灶(≤3 cm)的診斷價值[J].南華大學學報·醫學版, 2008, 36(4): 473-475．.

West China Medical Journal

CT Guided Percutaneous Osteoplasty of Ilium to Treat Metastatic Tumor of Ilium

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