PKP与PVP治疗骨质疏松性椎体骨折疗效和安全性的系统评价

发布时间：2018-11-09 07:41

【摘要】：背景目前,经皮椎体后凸成形术(PKP)和经皮椎体成形术(PVP)技术已广泛应用于临床骨质疏松性椎体骨折的微创外科治疗,对两种术式的选择在临床上还没有严格统一的选择标准。目的对国内外发表的经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松性椎体骨折的随机对照试验、临床对照试验进行系统评价,为临床应用提供一定的证据并为下一步研究指导方向。方法计算机检索1998年1月至2012年1月的The Cochrane Library、PubMed、EMBASE.美国科学引文索引数据库、中国生物医学文献数据库、中国学术期刊网络出版总库、数据化期刊全文数据库和1998年1月至2011年12月的中文科技期刊数据库,手工检索谷歌、雅虎和百度等综合搜索引擎,筛选研究收集数据后,分析数据并进行系统评价,解释结果并得出结论。结果共纳入5个相关研究,研究结果提示,PEP组与PVP组在术后1月内、术后6月、术后1年的VAS评分比较,差异无统计学意义(P0.05)；两组分别在腰部疼痛程度和Oswestry评分方面比较,差异无统计学意义(P0.05)；两组术后椎体高度比较,差异无统计学意义(P0.05),但敏感性分析示该结果可信度不大；两组术后1月内、术后6月、术后1年的椎体高度压缩率比较,PKP组低于PVP组(P0.05)；两组术后1月内、术后6月、术后1年的后凸角比较,PKP组低于PVP组(P0.05)；两组分别在手术时间、骨水泥量及邻椎骨折方面比较,差异无统计学意义(P0.05)：两组骨水泥渗漏情况比较,PKP组安全性高于PVP组(P0.05)。结论 PKP对椎体高度的恢复及椎体后凸畸形的矫正优于PVP,并且在在骨水泥渗漏的安全性方面优于PVP。
[Abstract]:Background at present, percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) have been widely used in minimally invasive surgical treatment of osteoporotic vertebral fractures. There is no strict and uniform criteria for the selection of the two surgical procedures in clinical practice. Objective to evaluate the randomized controlled trials and clinical controlled trials of percutaneous kyphoplasty and percutaneous vertebroplasty for osteoporotic vertebral fractures published at home and abroad. To provide some evidence for clinical application and guide future research. Methods computer retrieval of The Cochrane Library,PubMed,EMBASE. from January 1998 to January 2012 American Science Citation Index Database, Chinese Biomedical Literature Database, Chinese academic Journals Network Publishing Master Database, full text Database of Chinese academic Journals and Chinese Sci-tech Journals Database from January 1998 to December 2011. Yahoo and Baidu and other comprehensive search engines, screening research data collection, data analysis and systematic evaluation, interpretation and conclusions. Results five related studies were included. The results showed that there was no significant difference in VAS scores between PEP group and PVP group within 1 month, 6 months and 1 year after operation (P0.05). There was no significant difference in lumbar pain and Oswestry score between the two groups (P0.05), but there was no significant difference in vertebral height between the two groups (P0.05), but the sensitivity analysis showed that the reliability of the results was not significant. The vertebral height compression ratio in the PKP group was lower than that in the PVP group (P0.05), and the kyphoid angle in the PKP group was lower than that in the PVP group within 1 month, 6 months and 1 year after operation (P0.05). There was no significant difference in operation time, bone cement content and adjacent vertebral fracture between the two groups (P0.05). The safety of PKP group was higher than that of PVP group (P0.05). Conclusion PKP is superior to PVP, in the recovery of vertebral height and correction of kyphosis and is superior to PVP. in the safety of bone cement leakage.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R687.3

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