| 分离手术治疗伴有神经症状的脊柱转移瘤 |
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投稿时间：2024-11-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 王强 |
WANG Qiang |
宁波大学附属第一医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 陆旻昊 |
LU Min-hao |
宁波大学附属第一医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 王兴武 |
WANG Xing-wu |
宁波大学附属第一医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 方明 |
FANG Ming |
宁波大学附属第一医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 俞武良 |
YU Wu-liang |
宁波大学附属第一医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 陆建猛 |
LU Jian-meng |
宁波大学附属第一医院脊柱外科, 浙江 宁波 315000 |
Department of Spinal Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
lujianmeng2019@163.com |
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| 期刊信息：《中国骨伤》2025年，第38卷，第2期，第157-163页 |
| DOI：10.12200/j.issn.1003-0034.20240153 |
| 基金项目: |
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中文摘要:
目的: 探讨分离手术应用于伴神经症状的脊柱转移瘤患者的安全性和有效性。
方法: 自2020年1月至2022年12月收治25例伴神经症状的脊柱转移瘤患者,其中14例行分离手术,男7例,女7例,年龄30~76(61.57±12.16)岁;11例行保守治疗,男6例,女5例;年龄46~88(66.55±12.32)岁。比较两组患者治疗前后视觉模拟评分(visual analogue scale,VAS)、Frankel分级、Karnofsky评分、生活质量评分(quality of life,QOL)等变化情况。
结果: 分离手术组14例患者,手术时间(218.57±50.00) min,术中出血量(864.29±332.97) ml,2例出现迟发性血肿,经急诊手术后恢复良好,术后随访3~36个月,术后疼痛明显缓解,神经功能恢复良好。保守治疗组11例患者随访3~12个月,随访期间10例去世。治疗3个月后,分离手术组VAS(1.43±0.76)分,低于保守治疗组(8.64±0.51)分,差异有统计学意义(P<0.05),Frankel分级、Karnofsky评分、QOL评分均优于保守治疗组(P<0.05)。
结论: 对于神经症状明显的脊柱转移瘤患者而言,分离手术不仅能够迅速缓解神经压迫,而且手术风险相对较小,能够在一定程度上提高患者的生存质量。 |
| 【关键词】分离手术 脊柱转移瘤 神经症状 |
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| Clinical efficacy of separation surgery in treating spinal metastases accompanied by neurological symptoms |
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ABSTRACT
Objective To explore the safety and effectiveness of separation surgery in patients with neurological symptoms of spinal metastases.
Methods From January 2020 to December 2022,14 patients with neurological symptoms of spinal metastases underwent separation surgery,including 7 males and 7 females,aged from 30 to 76 years old with an average of (61.57±12.16) years old. In comparison with eleven patients underwent conservative treatment during the same period,including 6 males and 5 femals,aged from 46 to 88 years old with an average of (66.55±12.32) years old. The changes in visual analogue scale (VAS),Frankel grades,Karnofsky scores,and quality of life score (QOL) before and after treatment were compared between two groups.
Results Fourteen patients in the separation surgery group underwent surgery successfully,with surgery time of (218.57±50.00) minutes and intraoperative blood loss of (864.29±332.97) ml,2 patients developed delayed hematoma and recovered well finally after emergency surgery,the follow-up time was 3 to 36 months,after separation surgery,the pain was significantly relieved,and neurological function recovered well in the patients. Three months after treatment,the VAS in the separation surgery group (1.43±0.76) scores was significantly lower than that in the conservative treatment group (8.64±0.51) scores (P<0.05);and the Frankel grades,Karnofsky scores,and QOL scores in the separation surgery group were significantly better than those in the conservative treatment group(P<0.05).
Conclusion For patients with obvious neurological symptoms of spinal metastases,separation surgery not only can rapidly relieve nerve compression but also carry relatively low surgical risks,and improve the quality of life of patients. |
| KEY WORDS Separation surgery Spinal metastases Neurological symptom |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王强,陆旻昊,王兴武,方明,俞武良,陆建猛.分离手术治疗伴有神经症状的脊柱转移瘤[J].中国骨伤,2025,38(2):157~163 |
| 英文格式: | WANG Qiang,LU Min-hao,WANG Xing-wu,FANG Ming,YU Wu-liang,LU Jian-meng.Clinical efficacy of separation surgery in treating spinal metastases accompanied by neurological symptoms[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(2):157~163 |
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