经皮穿刺椎体成形术在多发性骨髓瘤所致椎体病理性骨折治疗中的疗效分析

摘要

目的 探讨经皮穿刺椎体成形术(PVP)在多发性骨髓瘤(MM)所致椎体病理性骨折治疗中的价值.方法 21例MM患者的35个病变椎体接受PVP治疗,比较患者不同时段的疼痛VAS评分及日常生活自理能力(ADL)评分.结果 所有椎体均穿刺成功,术中未出现肺栓塞、肋骨骨折、神经症状等并发症.术中发生骨水泥沿椎体静脉丛渗漏2例.所有患者在接受手术后3 d内疼痛情况均得到良好缓解,术前疼痛VAS评分为(6.9±0.8)分,术后3个月为(1.5±1.0)分,术后6个月为(1.3±1.0)分,差异均有统计学意义(P<0.05).术后6个月ADL评分为(45.0±11.0)分,较术前的(78.0±10.0)分明显改善,差异有统计学意义(P<0.05).术后随访至今患者疼痛无加重,手术椎体均未再发骨折.结论 对于脊柱MM所致椎体病理性骨折患者,PVP治疗临床疗效好,能够改善患者生活质量,缓解疼痛,值得临床推广应用.%Objective To investigate the clinical effect of percutaneous vertebral angioplasty(PVP) in the treat-ment of vertebral pathological fracture of multiple myeloma (MM).Methods Twenty-one patients with MM were treated with PVP for 35 centrum.The pain VAS score and daily life self-care ability(ADL) scores were analyzed in the different time.Results all the vertebral bodies were successfully punctured,and there were no complications such as pulmonary embolism,rib fracture and neurological symptoms.Intraoperative bone cement leakage in 2 cases of vertebral venous plexus.All the patients received surgery within 3 d after the pain all get good relief,the preoperative pain score was(6.9±0.8),3 months after operation(1.5±1.0),6 months after operation(1.3±1.0),the difference was statistically significant(P<0.05).In 6 months after surgery,the ADL score(45.0±11.0) was significantly improved compared with the preoperative score(78.0±10.0)(P<0.05).There was no aggravation of pain in patients after surgery,and no fracture of vertebral body.Conclusion For pathological vertebral fractures of spinal MM,PVP is safe and effect,can improve the quality of life,relieve pain.