胸腰椎骨折PKP术后疼痛缓解与若干因素的关系

发布时间：2018-04-10 02:10

本文选题：PKP　切入点：单双侧入路　出处：《福建中医药大学》2015年硕士论文

【摘要】：目的：通过观察、分析经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)对椎体压缩性骨折术后疼痛的影响,探讨性别、单双侧入路、骨密度和骨水泥注射量与PKP治疗椎体压缩性骨折术后疼痛缓解的关系。方法：本课题以莆田学院附属医院微创脊柱外科2013.03.01至2015.03.31期间收住入院的患者(发生新鲜骨质疏松性单椎体压缩骨折)为研究对象,将条件适合并同意行PKP手术之患者按要求分别行单侧入路PKP手术和双侧入路PKP手术,收集记录术前、术后即时、术后站立5分钟时疼痛缓解情况。疼痛采用视觉模拟评分法(visual analogue scale, VAS)评分,然后按性别(男性组、女性组)、骨密度(骨密度较优组、骨密度较差组)、单双侧入路(单侧入路组、双侧入路组)、骨水泥注射量(骨水泥注射量较大组、骨水泥注射量较小组),通过对数据进行整理、比较、分析,‘客观评价性别、单双侧入路、骨密度和骨水泥注射量与PKP治疗椎体压缩性骨折术后疼痛缓解的的关系。统计数据用X±S表示,使用SPSS18.0软件处理,采用两独立样本的非参数检验(Mann-Whitney test秩和检验)统计分析,P0.05表示数据差异性显著,P0.01表示数据差异性极显著。结果：骨密度：骨密度较优组术后疼痛缓解效果优于骨密度较差组,两组术前减术后即时VAS评分、术前减术后站立5分钟时VAS评分差异有统计学意义(P0.05)；性别：男性组与女性组术后痛缓解效果无差别,两组术前减术后即时VAS评分、术前减术后站立5分钟时VAS评分差异无统计学意义(P0.05)；单双侧入路：单侧入路组与双侧入路组术后痛缓解效果无差别,两组术前减术后即时VAS评分、术前减术后站立5分钟时VAS评分差异无统计学意义(P0.05)；骨水泥注射量：骨水泥注射量较大组与骨水泥注射量较小组术后痛缓解效果无差别,两组术前减术后即时VAS评分、术前减术后站立5分钟时VAS评分差异无统计学意义(P0.05)。结论：1、骨密度T值与PKP治疗椎体压缩性骨折术后疼痛缓解有关系；2、性别、单双侧入路和骨水泥注射量与PKP治疗椎体压缩性骨折术后疼痛缓解无关系。
[Abstract]:Objective: to analyze the effect of percutaneous kyphoplast PKP (percutaneous kyphoplast PKP) on postoperative pain after vertebral compression fracture, and to explore gender, unilateral and bilateral approach.Relationship between bone mineral density and bone cement injection and pain relief after treatment of vertebral compression fracture with PKP.Methods: the patients (fresh osteoporotic single vertebral compression fracture) who were admitted to hospital during the period from March 1 to March 31, 2013.03.2013.2013.03.2013.were studied in this study.Patients who agreed to PKP were treated with unilateral PKP and bilateral PKP respectively. The pain relief was recorded before operation, immediately after operation, and 5 minutes after operation.Visual analogue scale (vas) score was used to evaluate the pain, and then according to sex (male group, female group, bone mineral density (BMD) group, BMD group, unilateral and bilateral approach group (unilateral approach group).Bilateral approach group, bone cement injection volume (bone cement injection volume group, bone cement injection volume than small group, through the data collation, comparison, analysis of the objective evaluation of gender, unilateral and bilateral approach,Relationship between bone mineral density and bone cement injection and pain relief after PKP treatment of vertebral compression fractures.The statistical data were expressed by X 卤S, processed by SPSS18.0 software, and analyzed by non-parametric test (Mann-Whitney test test sum test) of two independent samples.Results: BMD: the pain relief effect of BMD group was better than that of BMD group. The VAS score of two groups was reduced immediately after operation.There was significant difference in VAS score between male group and female group after 5 minutes of postoperatively standing, gender: there was no difference between male group and female group in postoperative pain relief, and the immediate VAS score was decreased immediately after operation in both groups, and there was no significant difference between male group and female group (P < 0.05).There was no significant difference in VAS score between the two groups at 5 minutes after operation, and there was no difference between the unilateral approach group and the bilateral approach group in postoperative pain relief. The immediate VAS score was decreased immediately after operation in the two groups, and there was no significant difference between the two groups before and after operation.There was no significant difference in VAS score between the two groups after 5 minutes of standing before and after operation, and the volume of bone cement injection: there was no difference between the larger volume of bone cement injection and the volume of bone cement injection compared with the group of postoperative pain relief. The immediate VAS score of the two groups was reduced immediately after operation.There was no significant difference in VAS score between preoperative and postoperative standing for 5 minutes (P 0.05).Conclusion the T value of bone mineral density is related to the pain relief after PKP treatment of vertebral compression fracture. Gender, unilateral and bilateral approach and the amount of cement injection are not related to the postoperative pain relief of PKP in the treatment of vertebral compression fracture.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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