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目的探讨应用外科手术联合骨水泥灌注治疗椎体和四肢干骺端部位溶骨性转移癌的治疗效果。方法对椎体转移癌出现椎体严重破坏,有明显神经压迫症状者,行椎板减压,后路AF钉固定,病椎体行椎体成形术。对四肢干骺端部位出现病理性骨折者,先行骨折简单内固定或者外固定架固定,然后经皮穿刺病灶内骨水泥注射。手术后2周内辅助放疗或者化疗。结果经过0.5～2.0年的随访,全部14例患者手术后疼痛明显缓解,停用或者减少止痛药物的应用。9例椎体部位患者2～3周下床活动,5例肢体患者根据部位3～4周持拐下床活动。结论应用外科手术联合骨水泥灌注治疗椎体和四肢干骺端部位溶骨性转移癌能够明显缓解疼痛,早期下床活动,减少并发症的发生,改善生活质量,是治疗椎体和四肢干骺端部位溶骨性转移癌的有效方法。
Objective To investigate the therapeutic effect of surgical operation combined with bone cement infusion on the treatment of osteolytic metastasis of the vertebral body and the metaphysis of the extremities. Methods The patients with vertebral metastatic carcinoma had severe vertebral body destruction, obvious nerve compression symptoms, decompression of the lamina, posterior fixation with AF nail and vertebroplasty of the vertebral body. Pathological fractures of the limbs on the metaphysis site, the first simple fracture fixation or external fixator fixation, and then percutaneous puncture lesions of bone cement injection. Adjuvant radiotherapy or chemotherapy within 2 weeks after surgery. Results After 0.5 to 2.0 years of follow-up, all 14 patients had significant postoperative pain relief, discontinuation or reduced use of analgesic drugs. 9 cases of vertebral body patients get out of bed 2 to 3 weeks, 5 cases of limb patients according to the site of 3 to 4 weeks off the bed activities. Conclusion Surgical operation combined with bone cement infusion in the treatment of osteolytic metastasis of the vertebral body and the metaphysis of the extremities can significantly relieve pain, early ambulation, reduce the incidence of complications and improve the quality of life, is the treatment of vertebral body and limbs metaphyseal End of osteolytic metastatic cancer effective method.