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; 恶性肿瘤; 骨成形术; 转移瘤

DOI：

10.7507/1002-0179.20130224

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目的　探讨CT引导下髂骨成形术在治疗恶性肿瘤晚期髂骨转移中的价值。方法　对2009年3月－2011年8月收治的12例经病理活检证实为恶性肿瘤髂骨转移患者共，分别行CT引导下骨水泥注入髂骨成形术并观察该组患者治疗后的疼痛缓解、生活质量改善及生存期等。结果　该组患者手术后24 h内，疼痛与术前相比差异无统计学意义（t=2.433，P＞0.05），手术后3 d和7 d进行再次评估，与治疗前相比差异有统计学意义（t=3.123，3.124；P＜0.05）；术后该组患者在躯体功能、心理功能、社会功能、物质生活状态方面的生活质量评分显著高于手术前（t=2.341，2.354，3.567，3.124；P＜0.05）。该组总有效率为82.5%。且治疗后癌胚抗原（CEA）含量为（2.9 ± 0.9）μg/L，显著低于治疗前的（15.5 ± 3.2）μg/L（P＜0.01）。所有患者随访1年，其6、10、12个月的总生存率分别为15.2%、32.8%、52.0%，平均生存时间10.4个月。该组患者治疗后并发症情况发生率58.3%，均为出现了无症状的骨水泥渗漏现象，注射治疗后持续时间为0.5～3 h，平均1.87 h。结论　髂骨成形术短期内可明显减轻恶性肿瘤髂骨转移所致的疼痛症状。CT引导下髂骨成形术安全、可靠、近期疗效确切，是姑息性治疗恶性肿瘤髂骨转移的有效方法之一。

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.	邓钢, 何仕诚, 滕皋军, 等. 经皮椎体成形术治疗脊椎恶性肿瘤[J]. 介入放射学杂志, 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, 胡凯文, 姜敏, 等. CT引导经皮穿刺骨成形术在恶性肿瘤骨破坏治疗中的应用[J]. 临床肿瘤学杂志, 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.	张战利, 张炎, 张俊玲, 等. 经皮椎体成形术治疗椎体恶性病变的临床应用[J]. 实用放射学杂志, 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引导下空心拉力螺钉内固定治疗复合体损伤[J]. 骨与关节损伤杂志, 2009, 12(08): 723-724.
13.	王争明, 陈新．多层螺旋CT在经皮穿刺肺组织活检中的应用价值[J]. 临床放射学杂志, 2008, 27(8): 1038-1041.
14.	李盛祥, 巩湘浩, 曹火乃．CT引导下经皮肺穿刺活检对肺部小病灶(≤3 cm)的诊断价值[J].南华大学学报·医学版, 2008, 36(4): 473-475．.

1. 　邓钢, 何仕诚, 滕皋军, 等. 经皮椎体成形术治疗脊椎恶性肿瘤[J]. 介入放射学杂志, 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, 胡凯文, 姜敏, 等. CT引导经皮穿刺骨成形术在恶性肿瘤骨破坏治疗中的应用[J]. 临床肿瘤学杂志, 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. 　张战利, 张炎, 张俊玲, 等. 经皮椎体成形术治疗椎体恶性病变的临床应用[J]. 实用放射学杂志, 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引导下空心拉力螺钉内固定治疗复合体损伤[J]. 骨与关节损伤杂志, 2009, 12(08): 723-724.
13. 　王争明, 陈新．多层螺旋CT在经皮穿刺肺组织活检中的应用价值[J]. 临床放射学杂志, 2008, 27(8): 1038-1041.
14. 　李盛祥, 巩湘浩, 曹火乃．CT引导下经皮肺穿刺活检对肺部小病灶(≤3 cm)的诊断价值[J].南华大学学报·医学版, 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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