Li Meiling, Zhang Yan, Zhang Xiujuan
Department of Gynecology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China.
Department of General Surgery, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China.
Exp Ther Med. 2020 Feb;19(2):1072-1078. doi: 10.3892/etm.2019.8310. Epub 2019 Dec 10.
Effects of surgery and radiofrequency ablation in the treatment of spinal metastases were explored to analyze the influencing factors of prognosis. A total of 132 patients with spinal metastases admitted to Weifang People's Hospital were selected, 67 patients who underwent simple surgery were selected as the control group, and 65 patients who underwent radiofrequency ablation assisted surgery were the research group. The time of operation and intraoperative blood loss of patients in the two groups were recorded and compared. The visual analogue pain score (VAS), Karnofsky (KPS) score, Frankel spinal cord injury grading, and complications within 6 months after surgery were compared. The patients were followed up for 36 months and the survival rates were analyzed. Cox regression model was used to analyze the factors affecting the prognosis of patients. The time of operation and blood loss in the research group was significantly lower than that in the control group (P<0.05). The VAS, KPS scores, and Frankel grading of patients in the two groups after treatment were significantly improved compared with those before treatment, but the VAS and KPS scores of patients in the research group were significantly improved compared with those in the control group (P<0.05). The incidence rate of complications and 3-year recurrence rate in the research group were lower than those in the control group, and the 3-year survival rate was significantly higher than that in the control group (P<0.05). The number of pathological cones, visceral metastasis, malignant degree, and radiofrequency ablation therapy are independent risk factors for poor prognosis of patients. Radiofrequency ablation assisted surgery can effectively improve the clinical efficacy of patients with spinal metastases, reduce postoperative complications and recurrence rate of patients, and prolong the survival time of patients compared with simple surgical treatment. It is worthy of clinical application.
探讨手术及射频消融治疗脊柱转移瘤的效果，分析预后的影响因素。选取潍坊市人民医院收治的132例脊柱转移瘤患者，将67例行单纯手术的患者作为对照组，65例行射频消融辅助手术的患者作为研究组。记录并比较两组患者的手术时间及术中出血量。比较视觉模拟疼痛评分（VAS）、卡氏功能状态评分（KPS）、Frankel脊髓损伤分级及术后6个月内的并发症情况。对患者进行36个月随访并分析生存率。采用Cox回归模型分析影响患者预后的因素。研究组的手术时间及出血量显著低于对照组（P<0.05）。两组患者治疗后的VAS、KPS评分及Frankel分级较治疗前均显著改善，但研究组患者的VAS及KPS评分较对照组显著改善（P<0.05）。研究组的并发症发生率及3年复发率低于对照组，3年生存率显著高于对照组（P<0.05）。病理椎体数、内脏转移、恶性程度及射频消融治疗是患者预后不良的独立危险因素。与单纯手术治疗相比，射频消融辅助手术可有效提高脊柱转移瘤患者的临床疗效，降低患者术后并发症及复发率，延长患者生存时间。值得临床应用。
