本文選題：PKP　切入點(diǎn)：單雙側(cè)入路　出處：《福建中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：通過(guò)觀察、分析經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)對(duì)椎體壓縮性骨折術(shù)后疼痛的影響,探討性別、單雙側(cè)入路、骨密度和骨水泥注射量與PKP治療椎體壓縮性骨折術(shù)后疼痛緩解的關(guān)系。方法：本課題以莆田學(xué)院附屬醫(yī)院微創(chuàng)脊柱外科2013.03.01至2015.03.31期間收住入院的患者(發(fā)生新鮮骨質(zhì)疏松性單椎體壓縮骨折)為研究對(duì)象,將條件適合并同意行PKP手術(shù)之患者按要求分別行單側(cè)入路PKP手術(shù)和雙側(cè)入路PKP手術(shù),收集記錄術(shù)前、術(shù)后即時(shí)、術(shù)后站立5分鐘時(shí)疼痛緩解情況。疼痛采用視覺(jué)模擬評(píng)分法(visual analogue scale, VAS)評(píng)分,然后按性別(男性組、女性組)、骨密度(骨密度較優(yōu)組、骨密度較差組)、單雙側(cè)入路(單側(cè)入路組、雙側(cè)入路組)、骨水泥注射量(骨水泥注射量較大組、骨水泥注射量較小組),通過(guò)對(duì)數(shù)據(jù)進(jìn)行整理、比較、分析,‘客觀評(píng)價(jià)性別、單雙側(cè)入路、骨密度和骨水泥注射量與PKP治療椎體壓縮性骨折術(shù)后疼痛緩解的的關(guān)系。統(tǒng)計(jì)數(shù)據(jù)用X±S表示,使用SPSS18.0軟件處理,采用兩獨(dú)立樣本的非參數(shù)檢驗(yàn)(Mann-Whitney test秩和檢驗(yàn))統(tǒng)計(jì)分析,P0.05表示數(shù)據(jù)差異性顯著,P0.01表示數(shù)據(jù)差異性極顯著。結(jié)果：骨密度：骨密度較優(yōu)組術(shù)后疼痛緩解效果優(yōu)于骨密度較差組,兩組術(shù)前減術(shù)后即時(shí)VAS評(píng)分、術(shù)前減術(shù)后站立5分鐘時(shí)VAS評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P0.05)；性別：男性組與女性組術(shù)后痛緩解效果無(wú)差別,兩組術(shù)前減術(shù)后即時(shí)VAS評(píng)分、術(shù)前減術(shù)后站立5分鐘時(shí)VAS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；單雙側(cè)入路：?jiǎn)蝹?cè)入路組與雙側(cè)入路組術(shù)后痛緩解效果無(wú)差別,兩組術(shù)前減術(shù)后即時(shí)VAS評(píng)分、術(shù)前減術(shù)后站立5分鐘時(shí)VAS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；骨水泥注射量：骨水泥注射量較大組與骨水泥注射量較小組術(shù)后痛緩解效果無(wú)差別,兩組術(shù)前減術(shù)后即時(shí)VAS評(píng)分、術(shù)前減術(shù)后站立5分鐘時(shí)VAS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：1、骨密度T值與PKP治療椎體壓縮性骨折術(shù)后疼痛緩解有關(guān)系；2、性別、單雙側(cè)入路和骨水泥注射量與PKP治療椎體壓縮性骨折術(shù)后疼痛緩解無(wú)關(guān)系。
[Abstract]:Objective: to analyze the effect of percutaneous kyphoplast PKP (percutaneous kyphoplast PKP) on postoperative pain after vertebral compression fracture, and to explore gender, unilateral and bilateral approach.Relationship between bone mineral density and bone cement injection and pain relief after treatment of vertebral compression fracture with PKP.Methods: the patients (fresh osteoporotic single vertebral compression fracture) who were admitted to hospital during the period from March 1 to March 31, 2013.03.2013.2013.03.2013.were studied in this study.Patients who agreed to PKP were treated with unilateral PKP and bilateral PKP respectively. The pain relief was recorded before operation, immediately after operation, and 5 minutes after operation.Visual analogue scale (vas) score was used to evaluate the pain, and then according to sex (male group, female group, bone mineral density (BMD) group, BMD group, unilateral and bilateral approach group (unilateral approach group).Bilateral approach group, bone cement injection volume (bone cement injection volume group, bone cement injection volume than small group, through the data collation, comparison, analysis of the objective evaluation of gender, unilateral and bilateral approach,Relationship between bone mineral density and bone cement injection and pain relief after PKP treatment of vertebral compression fractures.The statistical data were expressed by X 鹵S, processed by SPSS18.0 software, and analyzed by non-parametric test (Mann-Whitney test test sum test) of two independent samples.Results: BMD: the pain relief effect of BMD group was better than that of BMD group. The VAS score of two groups was reduced immediately after operation.There was significant difference in VAS score between male group and female group after 5 minutes of postoperatively standing, gender: there was no difference between male group and female group in postoperative pain relief, and the immediate VAS score was decreased immediately after operation in both groups, and there was no significant difference between male group and female group (P < 0.05).There was no significant difference in VAS score between the two groups at 5 minutes after operation, and there was no difference between the unilateral approach group and the bilateral approach group in postoperative pain relief. The immediate VAS score was decreased immediately after operation in the two groups, and there was no significant difference between the two groups before and after operation.There was no significant difference in VAS score between the two groups after 5 minutes of standing before and after operation, and the volume of bone cement injection: there was no difference between the larger volume of bone cement injection and the volume of bone cement injection compared with the group of postoperative pain relief. The immediate VAS score of the two groups was reduced immediately after operation.There was no significant difference in VAS score between preoperative and postoperative standing for 5 minutes (P 0.05).Conclusion the T value of bone mineral density is related to the pain relief after PKP treatment of vertebral compression fracture. Gender, unilateral and bilateral approach and the amount of cement injection are not related to the postoperative pain relief of PKP in the treatment of vertebral compression fracture.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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