本文選題：椎體成形術(shù)　切入點(diǎn)：骨質(zhì)疏松性骨折　出處：《臨床骨科雜志》2016年01期 　論文類型：期刊論文

【摘要】：目的比較經(jīng)皮椎體成形術(shù)(PVP)治療新鮮與陳舊不愈合骨質(zhì)疏松性椎體壓縮骨折(OVCFs)的療效。方法 544例接受PVP手術(shù)患者,按照從受傷到手術(shù)時(shí)間的間隔將患者分為A組(新鮮骨折,3周,456例)和B組(陳舊骨折不愈合,8~24周,88例)。采用疼痛VAS評(píng)分對(duì)患者術(shù)前、離院時(shí)、術(shù)后3個(gè)月、術(shù)后1年進(jìn)行療效評(píng)價(jià)。結(jié)果 512例患者獲得為期1年的隨訪,隨訪率為94.1%,其中A組430例(492處骨折),B組82例(86處骨折)。骨水泥注射劑量:A組為3.2~8.0(5.6±0.05)ml,B組為3.0~7.6(6.0±0.04)ml,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。骨水泥滲漏率:A組為9.8%(42/430),B組為4.9%(4/82),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。VAS評(píng)分:A組術(shù)前為9.2分±0.06分,離院時(shí)為2.2分±0.07分,術(shù)后3個(gè)月時(shí)為2.3分±0.06分,術(shù)后12個(gè)月時(shí)為2.5分±0.05分,術(shù)后各時(shí)段與術(shù)前相比差異均有統(tǒng)計(jì)學(xué)意義(P0.05);B組術(shù)前為8.6分±0.05分,離院時(shí)為1.0分±0.07分,3個(gè)月時(shí)為1.1分±0.04分,術(shù)后12個(gè)月時(shí)為1.1分±0.03分,術(shù)后各時(shí)段與術(shù)前相比差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組VAS評(píng)分比較:術(shù)前差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),離院時(shí)、術(shù)后3個(gè)月及術(shù)后12個(gè)月差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 PVP通過(guò)骨水泥可以將陳舊OVCFs椎體內(nèi)的假關(guān)節(jié)牢固固定,不但可以達(dá)到解除疼痛的目的,而且顯著降低了骨水泥發(fā)生嚴(yán)重滲漏的風(fēng)險(xiǎn),療效優(yōu)于新鮮骨折。
[Abstract]:Objective to compare the efficacy of percutaneous vertebroplasty (PVP) in the treatment of fresh and old nonunion osteoporotic vertebral compression fractures (OVCFS). According to the interval from injury to operation, the patients were divided into two groups: group A (456 cases of fresh fracture 3 weeks) and group B (88 cases of non-union of old fracture at 824 weeks). The patients were treated with pain VAS score before operation and 3 months after operation. Results 512 patients were followed up for one year. The follow-up rate was 94. 1, of which there were 430 cases with 492 fractures in group A and 82 cases with 86 fractures in group B. the dose of bone cement injection in group A was 3. 2 鹵8. 6 鹵0. 05 ml / L, the difference was not statistically significant (P = 0. 05). The leakage rate of bone cement in group A was 9. 822 / 430%. The ratio of bone cement leakage in group B was 4. 9% / 42% and the difference was statistically significant (P = 0. 05. 0. 05%). VAS was significantly higher than that in group B (P < 0. 05. 0. 05%, P = 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05). The score in group A was 9.2 鹵0.06 before operation. It was 2.2 鹵0.07 when leaving hospital, 2.3 鹵0.06 at 3 months after operation and 2.5 鹵0.05 at 12 months after operation. There were significant differences between pre-operation and pre-operation in group B (8.6 鹵0.05). The VAS scores of the two groups were 1.0 鹵0.07, 1.1 鹵0.04 at 3 months and 1.1 鹵0.03 at 12 months after operation, respectively. There were significant differences in VAS scores between the two groups compared with those before operation (P 0.05). There was no significant difference between the two groups before operation (P 0.05), and there was no significant difference between the two groups (P 0.05). Conclusion PVP can fix the pseudarthrosis of the old OVCFs vertebral body through bone cement, which can not only relieve the pain. Moreover, the risk of serious leakage of bone cement was significantly reduced, and the effect was better than that of fresh fracture.
【作者單位】： 北京積水潭醫(yī)院脊柱外科;
【基金】：國(guó)家科技支撐計(jì)劃項(xiàng)目(編號(hào):2012BAI10B00) 北京市醫(yī)院管理局重點(diǎn)醫(yī)學(xué)專業(yè)項(xiàng)目(編號(hào):ZYLX201405)
【分類號(hào)】：R687.3
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本文編號(hào)：1651525