经皮椎体成形术治疗新鲜与陈旧不愈合骨质疏松性椎体压缩骨折疗效比较

发布时间：2018-03-23 02:30

  本文选题：椎体成形术　切入点：骨质疏松性骨折　出处：《临床骨科杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的比较经皮椎体成形术(PVP)治疗新鲜与陈旧不愈合骨质疏松性椎体压缩骨折(OVCFs)的疗效。方法 544例接受PVP手术患者,按照从受伤到手术时间的间隔将患者分为A组(新鲜骨折,3周,456例)和B组(陈旧骨折不愈合,8~24周,88例)。采用疼痛VAS评分对患者术前、离院时、术后3个月、术后1年进行疗效评价。结果 512例患者获得为期1年的随访,随访率为94.1%,其中A组430例(492处骨折),B组82例(86处骨折)。骨水泥注射剂量:A组为3.2~8.0(5.6±0.05)ml,B组为3.0~7.6(6.0±0.04)ml,差异无统计学意义(P0.05)。骨水泥渗漏率:A组为9.8%(42/430),B组为4.9%(4/82),差异有统计学意义(P0.05)。VAS评分:A组术前为9.2分±0.06分,离院时为2.2分±0.07分,术后3个月时为2.3分±0.06分,术后12个月时为2.5分±0.05分,术后各时段与术前相比差异均有统计学意义(P0.05);B组术前为8.6分±0.05分,离院时为1.0分±0.07分,3个月时为1.1分±0.04分,术后12个月时为1.1分±0.03分,术后各时段与术前相比差异均有统计学意义(P0.05)。两组VAS评分比较:术前差异无统计学意义(P0.05),离院时、术后3个月及术后12个月差异均有统计学意义(P0.05)。结论 PVP通过骨水泥可以将陈旧OVCFs椎体内的假关节牢固固定,不但可以达到解除疼痛的目的,而且显著降低了骨水泥发生严重渗漏的风险,疗效优于新鲜骨折。
[Abstract]:Objective to compare the efficacy of percutaneous vertebroplasty (PVP) in the treatment of fresh and old nonunion osteoporotic vertebral compression fractures (OVCFS). According to the interval from injury to operation, the patients were divided into two groups: group A (456 cases of fresh fracture 3 weeks) and group B (88 cases of non-union of old fracture at 824 weeks). The patients were treated with pain VAS score before operation and 3 months after operation. Results 512 patients were followed up for one year. The follow-up rate was 94. 1, of which there were 430 cases with 492 fractures in group A and 82 cases with 86 fractures in group B. the dose of bone cement injection in group A was 3. 2 卤8. 6 卤0. 05 ml / L, the difference was not statistically significant (P = 0. 05). The leakage rate of bone cement in group A was 9. 822 / 430%. The ratio of bone cement leakage in group B was 4. 9% / 42% and the difference was statistically significant (P = 0. 05. 0. 05%). VAS was significantly higher than that in group B (P < 0. 05. 0. 05%, P = 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05). The score in group A was 9.2 卤0.06 before operation. It was 2.2 卤0.07 when leaving hospital, 2.3 卤0.06 at 3 months after operation and 2.5 卤0.05 at 12 months after operation. There were significant differences between pre-operation and pre-operation in group B (8.6 卤0.05). The VAS scores of the two groups were 1.0 卤0.07, 1.1 卤0.04 at 3 months and 1.1 卤0.03 at 12 months after operation, respectively. There were significant differences in VAS scores between the two groups compared with those before operation (P 0.05). There was no significant difference between the two groups before operation (P 0.05), and there was no significant difference between the two groups (P 0.05). Conclusion PVP can fix the pseudarthrosis of the old OVCFs vertebral body through bone cement, which can not only relieve the pain. Moreover, the risk of serious leakage of bone cement was significantly reduced, and the effect was better than that of fresh fracture.
【作者单位】： 北京积水潭医院脊柱外科;
【基金】：国家科技支撑计划项目(编号:2012BAI10B00) 北京市医院管理局重点医学专业项目(编号:ZYLX201405)
【分类号】：R687.3
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本文编号：1651525