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闭合复位结合椎体成形术与椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的临床效果比较(1)
http://www.100md.com 2019年8月5日 《中国当代医药》 2019年第22期
     [摘要]目的 比较闭合复位结合椎体成形术(PVP)与椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCF)的临床效果。方法 选取2016年5月~2018年3月我院收治的82例OVCF患者,采用抽签法将其分为参照组和研究组,每组各41例。参照组采用PKP治疗,研究组采用闭合复位结合PVP治疗,比较两组视觉模拟量表(VAS)评分、椎体前缘高度、椎体中间高度、Cobb角、骨水泥渗漏率与邻椎骨折发生率。结果 两组治疗后的椎体前缘高度、Cobb角、VAS评分比较,差异无统计学意义(t=0.3440、0.5568、1.2258,P>0.05);研究组治疗后的椎体中间高度低于参照组(t=2.6558,P<0.05);研究组的骨水泥渗漏率、邻椎骨折发生率分别为17.07%、12.20%,稍高于参照组的7.32%、4.88%,但差异无统计学意义(χ2=1.8222、1.4057,P>0.05)。结论 在手术适应证严格把握的前提下,闭合复位结合PVP与PKP均能有效减轻OVCF患者的疼痛、矫正脊柱后凸畸形、恢复椎体前缘高度。

    [关键词]骨质疏松性;椎体压缩性骨折;闭合复位结合椎体成形术;椎体后凸成形术;比较分析

    [中图分类号] R683 [文献标识码] A [文章编号] 1674-4721(2019)8(a)-0083-03

    [Abstract] Objective To compare the clinical effect of closed reduction combined with vertebroplasty (PVP) and kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods From May 2016 to March 2018, 82 patients with OVCF were enrolled in our hospital. They were divided into the reference group and the study group according to the method of drawing, 41 cases in each group. The reference group was used PKP , the study group was treated with closed reduction combined with PVP. The visual analogue scale (VAS) score, vertebral body height, vertebral intermediate height, Cobb angle, cement leakage rate and incidence of adjacent vertebrae fractures were compared between the two groups. Results After treatment, the vertebral height, Cobb angle and VAS scores of the two groups were not significantly different between the two groups (t=0.3440, 0.5568, 1.2258, P>0.05). The intermediate height of the vertebral body in the reference group was higher than in the study group (t=2.6558, P<0.05). The incidence of cement leakage rate and adjacent vertebrae fracture in the study group were 17.07% and 12.20%, respectively, slightly higher than 7.32% and 4.88% of the reference group, but there was no significant difference between the groups(χ2=1.8222, 1.4057, P>0.05). Conclusion Under the premise of strict control of surgical indications, closed reduction combined with PVP and PKP can effectively alleviate pain, correct kyphosis and recovery of patients with OVCF. The height of the vertebral body leading edge.

    [Key words] Osteoporotic; Vertebra compressed fracture; Closed reduction combined with vertebroplast; Kyphoplasty; Comparative analysis

    手術是临床上治疗骨质疏松性椎体压缩性骨折(OVCF)的常用方式,椎体成形术(PVP)最先应用于颈椎血管瘤治疗中,后在骨质疏松引起的椎体压缩性骨折治疗中也得到了广泛应用,能达到快速止血目的,且安全性高[1]。但该手术方式在矫正脊柱后凸畸形、恢复椎体高度等方面有一定局限性[2]。随着医学研究的深入,椎体后凸成形术(PKP)出现在临床,该手术方式是在PVP基础上,采用气囊辅助治疗OVCF[3-4]。但因技术要求高、价格昂贵,在我国推广中受到了一定限制[5]。虽然闭合复位能促使部分压缩椎体高度恢复,但难以进行有效保持。本研究采用闭合复位结合PVP治疗OVCF,获得了理想的临床效果,现报道如下。, 百拇医药(王俊 杨翼众 胡水根 李东生)
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