本文選題：椎體成形術(shù) + 椎體壓縮骨折��； 參考：《福建醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:比較分析經(jīng)皮椎體成形術(shù)(percutaneous vertebroplasty,PVP)與保守方法治療有癥狀的骨質(zhì)疏松性椎體壓縮骨折(OVCF)的臨床療效分析。方法:回顧性分析2013年02月至2014年02月在福建省泉州市第一醫(yī)院骨科因骨質(zhì)疏松性脊柱骨折接受治療的143例患者的臨床資料。根據(jù)治療方法分為PVP組和保守組。對患者進(jìn)行入院時、手術(shù)后(1-3天)、手術(shù)后3個月、手術(shù)后6個月、手術(shù)后1年的療效評估,每個時間點(diǎn)的評估均采用視覺模擬評分量表(visual analogue scale,VAS)和Oswestry功能障礙指數(shù)(Oswestry Disability index,ODI)2種方法。隨訪1年,比較分析兩組隨訪結(jié)果并作統(tǒng)計(jì)學(xué)分析。結(jié)果:1共有143例患者符合納入標(biāo)準(zhǔn),剔除死亡及失訪患者13例,共120患者完成1年隨訪。其中保守組75例,PVP組55例。在PVP組患者中有1例發(fā)生骨水泥椎間隙滲漏,無明顯臨床癥狀。2 VAS評分:保守組的VAS評分入院時、術(shù)后(1-3天)、術(shù)后3個月、術(shù)后6個月、術(shù)后1年分別為(7.51±1.21)、(6.24±1.20)、(3.53±1.20)、(2.79±1.09)、(2.28±0.97)。保守組入院時和術(shù)后(1-3天)的VAS評分與術(shù)后3個月、術(shù)后6個月、術(shù)后1年的VAS評分差異有統(tǒng)計(jì)學(xué)意義(P0.05)。PVP組的VAS評分入院時、術(shù)后(1-3天)、術(shù)后3個月、術(shù)后6個月、術(shù)后1年分別為(7.40±1.03)、(3.56±0.96)、(2.69±1.14)、(2.58±0.94)、(2.40±1.10)。PVP組術(shù)后(1-3天)、術(shù)后3個月、術(shù)后6個月、術(shù)后1年的VAS評分,較入院時VAS評分差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。入院時兩組間的VAS評分差異無統(tǒng)計(jì)學(xué)意義(P0.05)。在術(shù)后(1-3天)、和術(shù)后3個月隨訪中的VAS評分,兩組存在差異存在統(tǒng)計(jì)學(xué)意義(P0.05);兩組在術(shù)后6個月和術(shù)后1年隨訪中的VAS評分差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。3 ODI指數(shù):保守組的ODI指數(shù)入院時、術(shù)后(1-3天)、術(shù)后3個月、術(shù)后6個月、術(shù)后1年分別為(75.23±6.80)、(73.96±6.39)、(47.88±5.77)、(41.00±6.43)、(31.23±6.86)。保守組入院時和術(shù)后(1-3天)的ODI指數(shù)與術(shù)后3個月、術(shù)后6個月、術(shù)后1年的ODI指數(shù)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。PVP組的ODI指數(shù)入院時、術(shù)后(1-3天)、術(shù)后3個月、術(shù)后6個月、術(shù)后1年分別為(73.01±7.34)、((48.77±5.99)、(43.92±5.17)、(39.60±6.51)、(32.32±7.67)。PVP組術(shù)后(1-3天)、術(shù)后3個月、術(shù)后6個月、術(shù)后1年的ODI指數(shù),較入院時ODI指數(shù)差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。入院時兩組間的ODI指數(shù)差異無統(tǒng)計(jì)學(xué)意義(P0.05)。在術(shù)后(1-3天)、和術(shù)后3個月隨訪中的ODI指數(shù),兩組存在差異存在統(tǒng)計(jì)學(xué)意義(P0.05);兩組在術(shù)后6個月和術(shù)后1年隨訪中的ODI指數(shù)差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。4本研究結(jié)果表明:PVP治療組在術(shù)后3個月內(nèi)的隨訪VAS評分、ODI指數(shù)明顯低于保守組,差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:PVP治療和保守方法兩種方法均可以有效的治療OVCF。但PVP治療OVCF患者,具有創(chuàng)傷小、操作簡便、手術(shù)時間短等特,能夠早期快速有效減輕患者痛苦、增加椎體骨強(qiáng)度、提高椎體穩(wěn)定性,從而使患者早期恢復(fù)活動功能,提高生活質(zhì)量,減少并發(fā)癥的發(fā)生和病死率。
[Abstract]:Objective: to compare and analyze the clinical effects of percutaneous vertebroplasty (PVP) and conservative method in the treatment of symptomatic osteoporotic vertebral compression fractures (OVCFCs). Methods: the clinical data of 143 cases of osteoporotic spinal fractures treated in the Department of Orthopaedics, Quanzhou first Hospital, Fujian Province from February 2013 to February 2014 were retrospectively analyzed. According to the treatment method, the patients were divided into PVP group and conservative group. On admission, 1 to 3 days after operation, 3 months after operation, 6 months after operation and 1 year after operation, the patients were evaluated by visual analogue scale (VASL) and Oswestry dysfunction index (Oswestry Disability index ODI). Follow-up 1 year, the two groups were compared the results of follow-up and statistical analysis. Results one hundred and thirty three patients met the inclusion criteria, 13 patients were excluded from death and lost visits, and 120 patients were followed up for one year. There were 75 cases in conservative group and 55 cases in PVP group. In the PVP group, there was one case with bone cement leakage with no obvious clinical symptoms. The VAS score of the conservative group was 1 to 3 days after admission, 3 months after operation, 6 months after operation, and 1 year after operation. The scores of VAS in conservative group were 7.51 鹵1.21, 3.53 鹵1.20, 2.79 鹵1.09 and 2.28 鹵0.97, respectively. The VAS score of the conservative group was significantly different from that of 3 months after operation, 6 months after operation and 1 year after operation. There were significant differences in VAS score of the conservative group on admission, 1-3 days after operation, 3 months after operation and 6 months after operation, and there was a significant difference in VAS score between 3 months and 6 months after operation in the conservative group at admission, 3 months after operation, 6 months after operation, and 1 to 3 days after operation. At 1 year after operation, the VAS scores in the group of 3.56 鹵0.96 and 2.69 鹵1.14 were 2.58 鹵0.94 and 2.40 鹵2.40 鹵1.10).PVP, respectively. The VAS scores of 3 months, 6 months and 1 year after operation were significantly higher than those at admission (P 0.05). There was no significant difference in VAS score between the two groups at admission (P 0.05). VAS scores were measured at 1 to 3 days after operation and 3 months after operation. There were significant differences in VAS scores between the two groups at 6 months after operation and 1 year after operation, and there was no significant difference in VAS scores between the two groups. The index of ODI in the conservative group was 1-3 days after admission, 3 months after operation, 6 months after operation, 3 days after admission, 6 months after operation, 3 days after admission, 3 months after operation, 6 months after operation, and 1 to 3 days after operation in the conservative group. At one year after operation, 75.23 鹵6.80 were 73.96 鹵6.39, 47.88 鹵5.77, 41.00 鹵6.43, 31.23 鹵6.86, respectively. The ODI index of conservative group was significantly different from that of 3 months after operation, 6 months after operation and 1 year after operation. There were significant differences in ODI index between 3 days after admission, 3 months after operation, 6 months after operation, and 1 to 3 days after operation, and 6 months after operation in the conservative group at admission, 3 months after operation and 6 months after operation, and 1 to 3 days after admission, 3 months after operation and 6 months after operation. At one year after operation, the ODI index in the group of 39.60 鹵6.51 and 32.32 鹵7.67).PVP was 73.01 鹵7.34, 48.77 鹵5.99, 39.60 鹵6.51 and 32.32 鹵7.67).PVP, respectively, and the ODI index of 3 months, 6 months and 1 year after operation was significantly higher than that at admission (P 0.05). There was no significant difference in ODI index between the two groups at admission (P 0.05). The ODI index was measured at 1-3 days after operation and 3 months after operation. There was no significant difference in ODI index between the two groups in 6 months after operation and 1 year after operation. The results of this study showed that the follow-up VAS score of the treatment group at 3 months after operation was similar to that of the control group. The number was significantly lower than that in the conservative group. The difference was statistically significant (P 0.05). Conclusion both the treatment of PVP and the conservative method can effectively treat OVCF. However, the treatment of OVCF by PVP has the advantages of small trauma, simple operation and short operation time. It can reduce the pain of patients quickly and effectively, increase the bone strength of vertebral body, improve the stability of vertebral body, and make the patients recover the function of movement in the early stage. Improve the quality of life, reduce the incidence of complications and mortality.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 楊惠林;;科學(xué)認(rèn)識椎體成形術(shù)與椎體后凸成形術(shù)的臨床價(jià)值[J];中國脊柱脊髓雜志;2010年06期

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