【摘要】：目的:探討新型骨水泥注射器(側(cè)方開口)在經(jīng)皮穿刺椎體成形術(shù)中的應(yīng)用,比較新型骨水泥注射劑和常規(guī)骨水泥注射器(垂直開口)的區(qū)別,評(píng)價(jià)新型骨水泥注射器在骨質(zhì)疏松性椎體骨折中的臨床應(yīng)用價(jià)值。方法:自2014年12月至2016年12月,共收治納入研究的骨質(zhì)疏松性椎體骨折病人42例,采用信封法隨機(jī)分組方案,隨機(jī)分成新型骨水泥注射器組(21例)和常規(guī)骨水泥注射器組(21例),分別應(yīng)用兩種不同的骨水泥注射器進(jìn)行治療。所有病例治療術(shù)式均采用經(jīng)皮穿刺椎體成形術(shù)(percutaneous vertebroplasty,PVP),入路均采用椎弓根入路且單側(cè)穿刺,分別在多次透視下注入骨水泥,并記錄手術(shù)時(shí)間、術(shù)中透視次數(shù)、骨水泥注入量、手術(shù)前后疼痛視覺類比評(píng)分(visual analogue scale,VAS)和骨水泥滲漏情況。用統(tǒng)計(jì)學(xué)方法對(duì)數(shù)據(jù)進(jìn)行分析,比較兩組數(shù)據(jù)的統(tǒng)計(jì)學(xué)意義。結(jié)果:納入研究的病人42例,按照分組采用新型骨水泥注射器或常規(guī)骨水泥注射器進(jìn)行治療。所有病例術(shù)中骨水泥均順利推注,并無明顯的手術(shù)并發(fā)癥發(fā)生。手術(shù)時(shí)間:新型骨水泥注射器組36.29±3.80 min,常規(guī)骨水泥注射器組42.24±5.36min,兩組間比較有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。術(shù)中透視次數(shù):新型骨水泥注射器組10.90±1.45次,常規(guī)骨水泥注射器組15.86±1.77次,兩組間比較有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。骨水泥注入量:新型骨水泥注射器組4.07±0.53 ml,常規(guī)骨水泥注射器組4.16±0.57 ml,兩組間比較無統(tǒng)計(jì)學(xué)意義(P㧐0.05)。術(shù)后VAS評(píng)分:新型骨水泥注射器組2.82±0.58分,常規(guī)骨水泥注射器組2.63±0.17分,兩組間比較無統(tǒng)計(jì)學(xué)意義(P㧐0.05),而兩組病例術(shù)后VAS評(píng)分和術(shù)前比較均有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。骨水泥滲漏情況:新型骨水泥注射器組1例,常規(guī)骨水泥注射器組6例,兩組間比較有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。結(jié)論:采用新型骨水泥注射器治療骨質(zhì)疏松性椎體骨折可以顯著緩解病人疼痛,且和采用常規(guī)骨水泥注射器治療效果比較無差異。新型骨水泥注射器采用特殊的側(cè)方開口,在骨水泥的推注過程中可調(diào)整骨水泥的注入方向,通過預(yù)定的推注方法可縮短手術(shù)時(shí)間,降低術(shù)中透視次數(shù),一定程度上減少骨水泥滲漏的發(fā)生。
[Abstract]:Objective: to investigate the application of a new type of cement syringe (lateral opening) in percutaneous vertebroplasty, and to compare the difference between the new type of cement injection and the conventional cement injector (vertical opening). To evaluate the clinical value of new cement syringe in osteoporotic vertebral fracture. Methods: from December 2014 to December 2016, 42 patients with osteoporotic vertebral fracture were enrolled in the study. The patients were randomly divided into two groups: the new cement syringe group (21 cases) and the conventional bone cement syringe group (21 cases). All cases were treated by percutaneous vertebroplasty (percutaneous vertebroplasty,PVP), pedicle approach and unilateral puncture were used. Cement was injected into bone through multiple fluoroscopy. The time of operation and the times of intraoperative fluoroscopy were recorded. Bone cement injection, pain visual analogue score (visual analogue scale,VAS) and cement leakage before and after surgery. The statistical method was used to analyze the data and to compare the statistical significance of the two groups of data. Results: 42 patients were treated with new cement syringe or conventional bone cement syringe. All cases were successfully injected with bone cement during operation, and there were no obvious complications. Operation time: 36.29 鹵3.80 min, conventional bone cement syringe group 42.24 鹵5.36 minutes, the comparison between the two groups was statistically significant (P0. 05). The times of intraoperative fluoroscopy were 10.90 鹵1.45 times in the new type cement syringe group and 15.86 鹵1.77 times in the conventional bone cement syringe group. There was significant difference between the two groups (P0. 05). The amount of bone cement injection: 4.07 鹵0.53 ml, conventional bone cement syringe group had no significant difference between the two groups (P0. 05). Postoperative VAS score: 2.82 鹵0.58 in the new type cement syringe group and 2.63 鹵0.17 in the conventional cement syringe group. There was no significant difference between the two groups (P0. 05). VAS score and preoperative comparison were statistically significant between the two groups (P0. 05). The leakage of bone cement: new cement syringe group (1 case) and conventional cement syringe group (6 cases). There was significant difference between the two groups (P0. 05). Conclusion: the treatment of osteoporotic vertebral fracture with a new type of bone cement syringe can significantly relieve the pain of the patients, and there is no difference between the treatment effect of the new cement syringe and that of the conventional cement syringe. The new type of cement syringe adopts special lateral openings, which can adjust the direction of cement injection during the injection of bone cement. The operation time can be shortened and the times of fluoroscopy can be reduced by the preset injection method. To some extent, the occurrence of cement leakage is reduced.
【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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本文編號(hào)：2299327