本文關鍵詞： 椎體成形術 骨水泥滲漏 穿刺方法 骨質(zhì)疏松　出處：《中國老年學雜志》2017年16期 　論文類型：期刊論文

【摘要】：目的比較不同穿刺方向的椎體成形術(PVP)治療老年骨質(zhì)疏松椎體壓縮性骨折的臨床療效。方法老年骨質(zhì)疏松椎體壓縮性骨折行PVP治療188例(214節(jié)椎體),根據(jù)不同的穿刺方向分為3組,A組為經(jīng)椎弓根向椎體上1/3方向穿刺,B組為向中1/3方向穿刺,C組為下1/3方向穿刺,對所有患者進行術前1 d、術后1 d、1 w的疼痛視覺模擬評分(VAS),術前及術后1 w進行功能障礙(ODI)評分,術后復查X線片及CT檢查評估骨水泥滲漏率。結果 3組VAS及ODI評分術前、術后比較差異有統(tǒng)計學意義(P0.01),但各組間差異無統(tǒng)計學意義(P0.05)。A組穿刺法與其他兩組骨水泥滲漏率比較有明顯統(tǒng)計學意義(P0.01),B、C組差異無統(tǒng)計學意義(P0.05),同一穿刺方向的椎體球囊擴張后凸成形術(PKP)法與PVP法比較差異有明顯統(tǒng)計學意義(P0.01)。結論經(jīng)椎弓根向椎體上1/3穿刺進針方向行PVP治療老年骨質(zhì)疏松壓縮性骨折可以有效減少骨水泥的滲漏,且無論哪種進針方向PKP較PVP骨水泥滲漏率低。
[Abstract]:Objective to compare the clinical effects of vertebroplasty with different puncture directions in the treatment of senile osteoporotic vertebral compression fractures. Methods PVP was performed in 188 patients with osteoporotic vertebral compression fractures. The puncture direction was divided into 3 groups. Group A was punctured through pedicle to the upper vertebral body in 1/3 direction. Group B was punctured in the middle and 1/3 directions. Group C was punctured in the lower 1/3 direction. All patients were assessed with visual analogue score of pain 1 day before operation, visual analogue score of pain 1 week after operation, dysfunction score before and 1 week after operation. The rate of bone cement leakage was evaluated by X-ray and CT examination after operation. Results the VAS and ODI scores were evaluated before and after operation. The difference was statistically significant (P 0.01), but there was no significant difference between the two groups. There was no significant difference in the leakage rate of bone cement between group A and the other two groups. There was no significant difference in the leakage rate of bone cement between group A and the other two groups. There was no significant difference between group A and group C (P 0.05%), but there was no significant difference between group A and group A (P 0.05%) in the same puncture direction. There was significant difference between kyphoplasty and PVP in the treatment of senile osteoporotic compression fractures. Conclusion PVP can effectively reduce the leakage of bone cement through the pedicle of vertebrae to the 1/3 puncture needle to the upper vertebral body in the treatment of osteoporotic compression fractures in the elderly. The leakage rate of PKP was lower than that of PVP.
【作者單位】： 福建醫(yī)科大學附屬南平第一醫(yī)院骨科;
【分類號】：R687.3

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