中国组织工程研究

中国组织工程研究

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

CT导引下经皮穿刺骨水泥注射治疗骨盆部位溶骨病变9例

宓士军，高景春，赵士军，周广军，高万旭，孙敬宇   

  1. 唐山市丰润区人民医院，河北省唐山市  064000
  • 出版日期:2010-02-19 发布日期:2010-02-19
  • 作者简介:宓士军★，男，1963年生，河北省唐山市人，汉族，2002年华北煤炭医学院毕业，硕士，主任医师，主要从事微创脊柱外科研究。 mishijunf@163.com

CT-guided percutaneous injection of bone cement for treating osteolysis pelvic disease in 9 cases

Mi Shi-jun, Gao Jing-chun, Zhao Shi-jun, Zhou Guang-jun, Gao Wan-xu, Sun Jing-yu   

  1. Department of Orthopaedics, Fengrui District People’s Hospital, Tangshan  064000, Hebei Province, China
  • Online:2010-02-19 Published:2010-02-19
  • About author:Mi Shi-jun★, Master, Chief physician, Department of Orthopaedics, Fengrui District People’s Hospital, Tangshan 064000, Hebei Province, China mishijunf@163.com

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摘要：

背景：骨盆是溶骨肿瘤常见发生部位，经皮骨水泥注射到病灶部位能达到稳定骨折，减轻疼痛甚或治疗肿瘤的作用，但骨水泥泄漏能引起严重并发症。
目的：探讨应用CT导引下经皮穿刺骨水泥注射治疗9例骨盆部位溶骨病变的方法以及治疗效果。
方法：在CT导引下，首先确定进针点和进针角度，按照病灶的大小和扫描的层数，计算病灶的容积，估计骨水泥的注射剂量。然后使用自行设计的三维穿刺导向器引导穿刺，按照手术前计算的容积略少于计算量0.2~0.5 mL注射骨水泥到骨盆溶骨破坏部位，充填满意后退出穿刺针。对穿刺的准确性、注射剂量、临床效果以及并发症进行观察和探讨。
结果与结论：全部病例完成5个月~4年，平均1.5年随访。手术后1~48 h症状缓解，完全缓解6例，部分缓解2例，轻微缓解1例。手术后CT扫描无病灶周围泄漏。提示经皮穿刺骨水泥注射是治疗不适应手术切除的骨盆溶骨病变的有效方法，具有安全、见效快、创伤小等优点。

关键词: 骨水泥, 溶骨病变, CT导引, 骨盆成形术, 生物材料

Abstract:

BACKGROUND: Osteolysis has always occurred in pelvis. Percutaneous injection of bone cement stabilized bone fracture, relieved pain or even treated tumor. However, leakage of bone cement might cause severe complications.
OBJECTIVE: To explore the therapeutic effect of percutaneous injection of bone cement on treating osteolysis pelvic disease in 9 cases by the CT guidance.
METHODS: By the CT guidance, needing degree was determined firstly. Focal size and scanning layers were used to calculate focal volume and estimate injected dose of bone cement. Three-dimensional targeting device was used to introduce the puncturation. The bone cement which was 0.2-0.5 mL less than the calculated volume was injected into osteolysis site. The accuracy, injected dose, clinical efficacy, and complications were investigated.
RESULTS AND CONCLUSION: The following-up ranged from 5 months to 4 years, with mean duration of 1.5 years. At 1-48 hours after operation, symptoms were recovered, including complete recovery (n=6), partial recovery (n=2), and light recovery (n=1). Leakage of bone cement was not detected out around focal region. This suggested that percutaneous injection of bone cement into the erosion site is an effective method to treat pelvic osteolysis disease, characterizing by security, effective, and less invasive.

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