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经皮骨成形术治疗骨盆和股骨转移性骨肿瘤所致疼痛的临床疗效

Clinical outcome of percutaneous osteoplasty for pain caused by metastatic bone tumors in the pelvis and femur.

作者信息

Yamada Keisuke, Matsumoto Yoshihisa, Kita Masaki, Yamamoto Ken, Kohda Wataru, Kobayashi Takeshi, Takanaka Tsuyoshi

机构信息

Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan.

出版信息

J Anesth. 2007;21(2):277-81. doi: 10.1007/s00540-007-0498-x. Epub 2007 May 30.

Abstract

We examined the pain-relieving effects in five patients who underwent percutaneous osteoplasty (POP) for pain caused by metastatic bone tumors in the pelvis and femur. Pain intensity, improvement of walking, and complications associated with POP were evaluated. Pain was measured using a numerical rating scale (NRS), with scores ranging from 0 (no pain) to 10 (worst pain imaginable). The patients were four men and one woman (mean age, 65 years). POP was performed in the pelvis in three patients and in the femur in two patients. Three of the subjects had already received radiation therapy at the lesion. The scores on the NRS on moving in the five patients before POP were 5, 8, 5, 4, and 7. After POP, the NRS scores decreased to 0, 0, 2, 0, and 1, respectively, within 72 hs. Three of the patients showed improvements in walking. There were no complications associated with POP. However, pathological fracture occurred, while walking, 4 days after POP in one patient. Percutaneous osteoplasty is a safe and effective treatment for pain caused by metastatic bone tumors in the pelvis and femur. However, care and attention should be paid to the risk of pathological fracture after POP of the femur.

摘要

我们对5例因骨盆和股骨转移性骨肿瘤引起疼痛而接受经皮骨成形术(POP)的患者的止痛效果进行了研究。评估了疼痛强度、步行改善情况以及与POP相关的并发症。使用数字评分量表(NRS)测量疼痛,分数范围为0(无疼痛)至10(可想象的最严重疼痛)。患者为4名男性和1名女性(平均年龄65岁)。3例患者在骨盆进行了POP,2例患者在股骨进行了POP。其中3名受试者已经在病变部位接受了放射治疗。5例患者在POP前移动时的NRS评分分别为5、8、5、4和7。POP后,NRS评分在72小时内分别降至0、0、2、0和1。3例患者的步行情况有所改善。未出现与POP相关的并发症。然而,1例患者在POP后4天行走时发生了病理性骨折。经皮骨成形术是治疗骨盆和股骨转移性骨肿瘤引起疼痛的一种安全有效的方法。然而,对于股骨POP后病理性骨折的风险应予以关注和重视。

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