骨质疏松性压缩骨折经皮穿刺椎体成形术后效果不佳的原因分析

发布时间：2018-03-16 18:31

本文选题：经皮椎体成形术　切入点：骨质疏松症　出处：《山东中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:通过分析经皮穿刺椎体成形术(Percutaneous Vertebroplasty,PVP)对骨质疏松性椎体压缩骨折治疗效果的相关资料,研究影响术后效果的因素,以提高PVP的临床疗效。方法:对2013年9月至2014年9月120例有完整资料的经PVP治疗患者进行研究,分别记录患者年龄、性别、骨折原因、骨折椎体数目、骨折椎体部位、骨密度等一般资料,记录手术中骨水泥注入量、是否发生骨水泥渗漏、椎体高度、cobb角、不同时间段VAS评分(视觉模拟评分)等,并对以上因素进行统计学分析。结果:术后120例患者随访4~8个月(平均6.7个月)。其中17名患者术后效果欠佳:6例术后症状缓解不明显,为胸椎压缩骨折,疼痛向胁肋部放射;5例术后活动时仍有腰背部疼痛,都有明显的外伤史;4例术后穿刺部位疼痛,术中有穿刺针位置反复调整或双侧反复椎弓根穿刺;2例术后症状缓解不明显,患者有严重的骨质疏松症且骨折椎体压缩率超过85%;8例在随访期间出现邻近椎体再骨折。结论:PVP治疗骨质疏松性椎体压缩骨折疗效确切,是一种针对骨质疏松性椎体压缩骨折的安全有效的治疗方法。仍有术后效果不佳者,严重骨质疏松症、骨水泥分布不均匀、骨折陈旧、胸椎骨折疼痛向双肋部放射者效果不佳。
[Abstract]:Objective: to analyze the data of percutaneous Vertebroplasty (Vertebroplasty) in the treatment of osteoporotic vertebral compression fracture, and to study the factors influencing the postoperative outcome. Methods: from September 2013 to September 2014, 120 patients treated with PVP were studied. Age, sex, fracture cause, number of fracture vertebrae, site of fracture vertebral body were recorded respectively. Bone mineral density and other general data, bone cement injection volume, whether bone cement leakage occurred, vertebral height and Cobb angle, VAS score (visual analogue score) in different periods of time were recorded, and so on. Results: 120 patients were followed up for 4 ~ 8 months (mean 6.7 months). There were 5 cases of pain radiating to the side of the flank, 5 cases still had pain in the waist and back, 4 cases had obvious traumatic history and 4 cases had pain in the puncture site, and 2 cases had repeated adjustment of puncture needle position or bilateral recurrent pedicle puncture in 2 cases, the symptom relief was not obvious after operation. Eight patients with severe osteoporosis and fracture vertebral compression rate over 85% had refracture of adjacent vertebral body during follow-up. Conclusion the treatment of osteoporotic vertebral compression fracture with PVP is effective. It is a safe and effective treatment for osteoporotic vertebral compression fracture. There are still patients with poor postoperative effect, severe osteoporosis, uneven distribution of bone cement, old fracture, chest fracture pain radiating to double ribs.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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