激素诱导骨质疏松性胸腰椎体骨折PVP后再发骨折分析

发布时间：2018-02-25 08:05

  本文关键词： 脊柱骨折 骨质疏松 激素诱导 再发骨折　出处：《重庆医学》2017年27期 　论文类型：期刊论文

【摘要】：目的探讨激素诱导骨质疏松性胸腰椎体骨折患者行经皮椎体成形术(PVP)后再发骨折的危险因素。方法选取2010年4月至2015年7月解放军第425中心医院收治的骨质疏松性胸腰椎体骨折患者646例,根据骨折类型分为原发性骨质疏松性胸腰椎体骨折(n=542)和激素诱导骨质疏松性胸腰椎体骨折(n=104),比较两组患者的再发骨折发生率。根据再发骨折发生情况将激素诱导骨质疏松性胸腰椎体骨折患者分为骨折组和无骨折组,对两组患者的临床资料进行单因素和多因素Logistic回归分析。结果原发性骨质疏松性胸腰椎体骨折患者再发骨折102例(18.82%),激素诱导骨质疏松性胸腰椎骨折患者再发骨折53例(50.96%)。骨折组和无骨折组患者的体质量指数、骨密度、骨水泥渗漏、术前椎体裂隙样变、未接受抗骨质疏松治疗比例差异有统计学意义(P0.05)。骨密度、骨水泥渗漏、术前椎体裂隙样变、未接受抗骨质疏松治疗是影响激素诱导骨质疏松性胸腰椎体骨折患者行PVP后再发骨折的独立危险因素(P0.05)。结论激素诱导骨质疏松性胸腰椎体骨折患者再发骨折风险较高,骨密度、骨水泥渗漏、术前椎体裂隙样变、是否接受抗骨质疏松治疗等是再发骨折的主要危险因素。
[Abstract]:Objective to investigate the risk factors of recurrent fracture after percutaneous vertebroplasty (PVP) in patients with osteoporotic thoracolumbar vertebral fracture induced by hormone. Methods Osteoporosis was selected from April 2010 to July 2015 in the 425th Central Hospital of PLA. 646 cases of thoracolumbar vertebral fracture, According to the type of fracture, the patients were divided into primary osteoporotic thoracolumbar vertebra fracture and steroid-induced thoracolumbar vertebral fracture. The incidence of recurrent fracture was compared between the two groups. The hormone was induced by hormone according to the occurrence of recurrent fracture. Patients with osteoporotic thoracolumbar vertebral body fracture are divided into fracture group and non-fracture group. The clinical data of the two groups were analyzed by univariate and multivariate Logistic regression analysis. Results 102 cases of recurrent fracture of primary osteoporotic thoracolumbar vertebral body fracture were treated with hormone induced osteoporotic thoracolumbar vertebra fracture. Body mass index (BMI) of 53 patients with fracture and without fracture, Bone mineral density (BMD), bone cement leakage (BMD), bone cement leakage (BMD), vertebral fissure like change before operation, no anti-osteoporosis treatment were significantly different (P < 0.05), bone mineral density (BMD), bone cement leakage (BMD), vertebral fissure like change before operation (P < 0.05), No anti-osteoporosis treatment was an independent risk factor for the recurrence of osteoporotic thoracolumbar vertebral fractures after PVP. Conclusion the risk of recurrent fractures in patients with steroid induced osteoporotic thoracolumbar vertebral fractures is higher and bone mineral density is higher than that in patients with steroid induced osteoporotic thoracolumbar vertebral fractures. The main risk factors for recurrent fracture are cement leakage, vertebral fissure-like change before operation and anti-osteoporosis treatment.
【作者单位】： 中国人民解放军第425中心医院脊柱骨科;海南医学院附属医院骨科;
【基金】：国家自然科学基金资助项目(81260271)
【分类号】：R580;R687.3
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本文编号：1533615