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目的探讨射频消融用于临床姑息性治疗骨转移瘤的可行性及临床疗效。方法2005年2月至2008年2月应用射频消融于8例骨转移瘤患者15处病灶。男6例,女2例;年龄37～72岁,平均47.4岁。随访3～18个月,平均6.5个月。手术前后行MR病灶扫描,进行影像学对比。疼痛视觉类比评分法(visual analoguescore,VAS)作为临床疗效评定指标。结果术后3～7d内因肿瘤引起的疼痛症状明显缓解,3个月内随访无明显变化。VAS评分明显降低,术前7.38±1.41,术后7 d2.75±0.79,3个月时2.25±0.21,术前后差异有统计学意义(P<0.05)。术后8例患者病理结果证实为骨转移瘤。术中、术后无严重并发症,末次随访局部肿瘤无复发。术后3个月复查MR T2加权像总显效率93.3%。结论CT引导下经皮穿刺射频消融技术姑息性治疗骨转移瘤是安全、有效、可行的,可选择作为治疗骨转移病灶疼痛的一种方法。
Objective To investigate the feasibility and clinical efficacy of radiofrequency catheter ablation in clinical palliative treatment of bone metastases. Methods From February 2005 to February 2008, radiofrequency ablation was performed in 15 lesions of 8 patients with bone metastases. 6 males and 2 females; aged 37 to 72 years, an average of 47.4 years old. Follow-up 3 to 18 months, an average of 6.5 months. MRI scan before and after surgery, imaging contrast. Visual analogues score (VAS) was used as the evaluation index of clinical curative effect. Results The symptoms of pain caused by the tumor were relieved within 3 to 7 days after operation, and no significant changes were observed within 3 months. VAS score was significantly lower, preoperative 7.38 ± 1.41, 7d2.75 ± 0.79, 3 months, 2.25 ± 0.21, the difference was statistically significant (P <0.05). Pathological results of 8 patients confirmed as bone metastases. No intraoperative and postoperative serious complications, the last follow-up local tumor recurrence. Three months after the review of the MR T2 weighted total effective rate was 93.3%. Conclusion CT-guided percutaneous radiofrequency ablation of palliative treatment of bone metastases is safe, effective and feasible, and can be used as a method to treat the pain of bone metastases.