老年骨质疏松椎体骨折PVP术后骨水泥渗漏的相关危险因素

发布时间：2018-06-23 08:00

本文选题：椎基静脉孔形态 + 经皮椎体成形术　；参考：《中国老年学杂志》2017年23期

【摘要】：目的探讨经皮椎体成形术(PVP)治疗老年骨质疏松椎体骨折术后骨水泥渗漏的相关危险因素,分析椎基静脉孔形态对PVP术后骨水泥渗漏的影响。方法选取行PVP治疗的老年骨质疏松椎体骨折患者为研究对象,根据术后是否发生骨水泥渗漏分为对照组(未渗漏)和观察组(渗漏)。比较两组临床资料,总结PVP术后骨水泥渗漏的危险因素。结果 180例患者中共38例(21.11%)发生椎内裂隙征,其中15例(39.47%)椎内裂隙征与椎基静脉孔相通;术后发生65例(36.11%)骨水泥渗漏,其中B型骨水泥渗漏34例(52.31%)最为多见;两组注射时期、骨水泥注入量、脊柱后突Cobb角、椎内裂隙征、椎基静脉孔相通、穿刺点差异有统计学意义(P0.05);多因素Logistic回归分析结果显示,粥状期注射、脊柱后突Cobb角大、椎内裂隙征与椎基静脉孔相通、单侧穿刺及骨水泥注入量大是PVP术后骨水泥渗漏的危险因素(P0.05)。结论椎内裂隙征和椎基静脉孔存在通道可能是增加骨水泥渗漏发生率的主要因素,临床应增加对存在椎内裂隙征患者的重视并采取有效措施防止其通过椎基静脉孔发生骨水泥渗漏。
[Abstract]:Objective to investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) in elderly patients with osteoporotic vertebral fracture and to analyze the effect of vertebral basal foramen morphology on bone cement leakage after PVP. Methods aged patients with osteoporotic vertebral fracture treated with PVP were divided into control group (without leakage) and observation group according to whether or not bone cement leakage occurred after operation. The clinical data of the two groups were compared and the risk factors of bone cement leakage after PVP were summarized. Results there were 38 cases (21.11%) with intravertebral fissure sign in 180 patients, 15 cases (39.47%) had intervertebral fissure sign and 65 cases (36.11%) had bone cement leakage, 34 cases (52.31%) had type B cement leakage. The amount of bone cement injection, the Cobb angle of spinal posterior process, the sign of intervertebral fissure, the connection of vertebral basal foramen, the difference of puncture point were statistically significant (P0.05), the results of multivariate logistic regression analysis showed that the Cobb angle of spinal posterior process was large during porridge injection. Intervertebral fissure sign and vertebrae vein foramen, unilateral puncture and large amount of bone cement injection were the risk factors of bone cement leakage after PVP (P0.05). Conclusion the intravertebral fissure sign and the existence of channels in vertebral basal foramen may be the main factors to increase the incidence of bone cement leakage. In clinic, more attention should be paid to patients with intravertebral fissure sign and effective measures should be taken to prevent bone cement leakage through vertebral base foramen.
【作者单位】：宁夏回族自治区人民医院;
【基金】：宁夏回族自治区科技攻关项目(2012ZYS203)
【分类号】：R687.3

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