新型骨水泥注射器在椎体成形术中的应用

发布时间：2018-10-30 07:20

【摘要】：目的:探讨新型骨水泥注射器(侧方开口)在经皮穿刺椎体成形术中的应用,比较新型骨水泥注射剂和常规骨水泥注射器(垂直开口)的区别,评价新型骨水泥注射器在骨质疏松性椎体骨折中的临床应用价值。方法:自2014年12月至2016年12月,共收治纳入研究的骨质疏松性椎体骨折病人42例,采用信封法随机分组方案,随机分成新型骨水泥注射器组(21例)和常规骨水泥注射器组(21例),分别应用两种不同的骨水泥注射器进行治疗。所有病例治疗术式均采用经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP),入路均采用椎弓根入路且单侧穿刺,分别在多次透视下注入骨水泥,并记录手术时间、术中透视次数、骨水泥注入量、手术前后疼痛视觉类比评分(visual analogue scale,VAS)和骨水泥渗漏情况。用统计学方法对数据进行分析,比较两组数据的统计学意义。结果:纳入研究的病人42例,按照分组采用新型骨水泥注射器或常规骨水泥注射器进行治疗。所有病例术中骨水泥均顺利推注,并无明显的手术并发症发生。手术时间:新型骨水泥注射器组36.29±3.80 min,常规骨水泥注射器组42.24±5.36min,两组间比较有统计学意义(P㩳0.05)。术中透视次数:新型骨水泥注射器组10.90±1.45次,常规骨水泥注射器组15.86±1.77次,两组间比较有统计学意义(P㩳0.05)。骨水泥注入量:新型骨水泥注射器组4.07±0.53 ml,常规骨水泥注射器组4.16±0.57 ml,两组间比较无统计学意义(P㧐0.05)。术后VAS评分:新型骨水泥注射器组2.82±0.58分,常规骨水泥注射器组2.63±0.17分,两组间比较无统计学意义(P㧐0.05),而两组病例术后VAS评分和术前比较均有统计学意义(P㩳0.05)。骨水泥渗漏情况:新型骨水泥注射器组1例,常规骨水泥注射器组6例,两组间比较有统计学意义(P㩳0.05)。结论:采用新型骨水泥注射器治疗骨质疏松性椎体骨折可以显著缓解病人疼痛,且和采用常规骨水泥注射器治疗效果比较无差异。新型骨水泥注射器采用特殊的侧方开口,在骨水泥的推注过程中可调整骨水泥的注入方向,通过预定的推注方法可缩短手术时间,降低术中透视次数,一定程度上减少骨水泥渗漏的发生。
[Abstract]:Objective: to investigate the application of a new type of cement syringe (lateral opening) in percutaneous vertebroplasty, and to compare the difference between the new type of cement injection and the conventional cement injector (vertical opening). To evaluate the clinical value of new cement syringe in osteoporotic vertebral fracture. Methods: from December 2014 to December 2016, 42 patients with osteoporotic vertebral fracture were enrolled in the study. The patients were randomly divided into two groups: the new cement syringe group (21 cases) and the conventional bone cement syringe group (21 cases). All cases were treated by percutaneous vertebroplasty (percutaneous vertebroplasty,PVP), pedicle approach and unilateral puncture were used. Cement was injected into bone through multiple fluoroscopy. The time of operation and the times of intraoperative fluoroscopy were recorded. Bone cement injection, pain visual analogue score (visual analogue scale,VAS) and cement leakage before and after surgery. The statistical method was used to analyze the data and to compare the statistical significance of the two groups of data. Results: 42 patients were treated with new cement syringe or conventional bone cement syringe. All cases were successfully injected with bone cement during operation, and there were no obvious complications. Operation time: 36.29 卤3.80 min, conventional bone cement syringe group 42.24 卤5.36 minutes, the comparison between the two groups was statistically significant (P0. 05). The times of intraoperative fluoroscopy were 10.90 卤1.45 times in the new type cement syringe group and 15.86 卤1.77 times in the conventional bone cement syringe group. There was significant difference between the two groups (P0. 05). The amount of bone cement injection: 4.07 卤0.53 ml, conventional bone cement syringe group had no significant difference between the two groups (P0. 05). Postoperative VAS score: 2.82 卤0.58 in the new type cement syringe group and 2.63 卤0.17 in the conventional cement syringe group. There was no significant difference between the two groups (P0. 05). VAS score and preoperative comparison were statistically significant between the two groups (P0. 05). The leakage of bone cement: new cement syringe group (1 case) and conventional cement syringe group (6 cases). There was significant difference between the two groups (P0. 05). Conclusion: the treatment of osteoporotic vertebral fracture with a new type of bone cement syringe can significantly relieve the pain of the patients, and there is no difference between the treatment effect of the new cement syringe and that of the conventional cement syringe. The new type of cement syringe adopts special lateral openings, which can adjust the direction of cement injection during the injection of bone cement. The operation time can be shortened and the times of fluoroscopy can be reduced by the preset injection method. To some extent, the occurrence of cement leakage is reduced.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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