目的: 探讨射频消融用于临床姑息性治疗骨转移瘤的可行性及临床疗效。方法: 2005年2月至2008年2月应用射频消融技术对8例骨转移瘤患者15处病灶部位实施治疗。其中男6例，女2例，年龄37～72岁，平均47.4岁。随访3～18个月，平均6.5个月。手术前后行MR病灶扫描，进行影像学对比。疼痛视觉类比评分法（visual analogue score VAS）作为临床疗效评定指标。结果:患者术后3～7天内因肿瘤引起的疼痛症状明显缓解，3个月内情况无明显变化。VAS评分明显降低，差异有统计学意义（P<0.05）。术后8例患者病理结果证实为骨转移瘤。术中、术后无严重并发症，末次随访局部肿瘤无复发。术后3个月复查MR T2加权像总显效率93.3。结论:CT引导下经皮穿刺射频消融技术姑息性治疗骨转移瘤是安全、有效、可行的，可选择作为一种临床治疗骨转移病灶疼痛的可靠方法。

[关键词] 骨转移；外科治疗；射频；消融术 ；穿刺术

【Abstract】Objective To discuss and evaluate the clinical effectiveness of the treatment of bone metastases by CT-guided percutaneous radiofrequency ablation (RFA). Methods From February 2005 to February 2008，8 patients with 15 diseased regions with the diagnosis of bone metastases were included in the study. There were 6 males and 2 females with an average age of 47.4 years (ranging from 37 to 72 ). The follow-up period is 18 to 24 months with an average of 19.5 months. A comparison of preoperative and postoperative MRI scans was conducted. And the pain visual analog score (VAS) was used as an evaluation parameter for measuring clinical effectiveness. Results All procedures were technically successful. No major complications occurred. No recurrence was observed at the end of the follow-up period. All patients gained significant pain release 3 days to one week and are pain-free ３ month after operation. Results at biopsy were positive in all patients. Postoperative MRI T2-weighted signal reduction for different patients is varied.The effective rate in 3 months after operation is 93.3. VAS score decreased sharply which is of significant statistical value (P<0.01) . Conclusions CT-guided percutaneous RFA is a safe effective and feasible method of palliative treatment for bone metastases. RFA can be choosed as a reliable method in clinical treatment of bone metastases.

【Key words】 Bone metastasis Surgical treatment Radiofrequency Ablation Punctures