唑来膦酸联合PKP治疗老年椎体压缩性骨折后椎体高度丢失的分析

发布时间：2018-05-08 16:19

本文选题：唑来膦酸 + PKP　；参考：《苏州大学》2015年硕士论文

【摘要】：目的：探讨唑来膦酸(密固达)联合PKP技术治疗老年椎体压缩性骨折的临床疗效。方法：回顾性分析我科于2012-2014年收治老年椎体压缩性骨折并行PKP技术治疗的病人,39例获得随访,依据PKP术后是否应用唑来膦酸治疗,分成对照组及实验组。所有病人分别于术后第1天、术后半年、术后1年测量侧位X光片上病椎及相邻上下椎体的前缘及后缘高度,同时进行VAS疼痛评分,评价治疗效果。结果：PKP术后半年后对照组患者病椎及相邻上下椎体前后缘高度显著下降,年后这一下降趋势更显著。PKP联合唑来膦酸治疗6个月及12个月后,实验组患者病椎前后缘高度的丢失明显低于对照组(P0.05)；联合治疗半年后,实验组中与病椎相邻下椎体前缘高度丢失明显低于对照组(P0.05),而两组间下椎体后缘高度无显著统计学差异(P0.05)。联合治疗并未减少上椎体前后缘高度的丢失(P0.05)。此外,实验组椎体疼痛症状较对照组缓解明显,VAS评分较对照组低,治疗后1年内无新发骨折。结论：唑来膦酸联合PKP治疗老年椎体压缩性骨折效果显著,可明显缓解术后病椎及相邻椎体高度的丢失,并有效减轻全身及胸腰部骨性疼痛症状。应用唑来膦酸给药方便、依从性较好,不良反应轻微、可达到全身系统化治疗,可作为椎体压缩性骨折PKP术后一种良好的辅助治疗措施。
[Abstract]:Objective: to investigate the clinical effect of zoledronic acid combined with PKP in the treatment of senile vertebral compression fracture. Methods: 39 cases of senile vertebral compression fracture treated with PKP technique from 2012 to 2014 were analyzed retrospectively. According to whether zoledronic acid was used after PKP, they were divided into control group and experimental group. The anterior and posterior edge height of the diseased vertebrae and adjacent upper and lower vertebrae were measured on the first day, half a year and one year after operation respectively. The VAS pain score was also used to evaluate the therapeutic effect. Results the height of the anterior and posterior margins of the diseased vertebrae and adjacent upper and lower vertebrae in the control group decreased significantly half a year after the operation, especially after 6 and 12 months of treatment with PKP combined with zoledronic acid. The loss of anterior and posterior edge height of the patients in the experimental group was significantly lower than that of the control group (P 0.05), and the loss of the anterior height of the inferior vertebral body adjacent to the diseased vertebra in the experimental group was significantly lower than that of the control group after six months of combined treatment, but there was no significant difference between the two groups in the height of the posterior edge of the lower vertebral body. Combined therapy did not reduce the loss of anterior and posterior edge height of the upper vertebral body (P 0.05). In addition, the VAS score of the experimental group was significantly lower than that of the control group, and there were no new fractures within 1 year after treatment. Conclusion: Zoledronic acid combined with PKP is effective in the treatment of senile vertebral compression fractures. It can significantly relieve the loss of the height of the diseased vertebrae and adjacent vertebrae and alleviate the symptoms of systemic and thoracolumbar bone pain. Zoledronic acid can be used as a good adjuvant treatment after PKP for vertebral compression fracture.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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