PKP、編織囊袋擴張椎體成形術在治療胸腰椎骨質(zhì)疏松性壓縮骨折的療效對比
發(fā)布時間：2018-12-15 15:55
【摘要】：目的:觀察并分析應用經(jīng)皮穿刺椎體后凸成形術(PKP)和編織囊袋擴張椎體成形術在治療骨質(zhì)疏松性椎體壓縮骨折(OVCF)的臨床療效。方法:2015年2月—2016年2月在我院接受治療的120例OVCF患者作為研究對象,隨機分為PKP組(n=60)和編織囊袋組(n=60)進行手術治療,觀察比較兩組患者手術時間,術前術后的疼痛情況、Cobb角,術后椎體后凸矯正率、骨水泥分布、骨水泥滲漏情況。根據(jù)統(tǒng)計數(shù)字評價與對比分析經(jīng)皮穿刺椎體后凸成形術(PKP)和編織囊袋擴張椎體成形術在治療胸腰椎骨質(zhì)疏松性壓縮骨折的臨床療效。結果:1.所有患者術后疼痛視覺評分(VAS)、Cobb角、較術前均有改善,差異有統(tǒng)計學意義(P0.05),組術后VAS評分比較,差異無統(tǒng)計學意義(P0.05),術后椎體后凸矯正囊袋率組優(yōu)于Pk P組,差異有統(tǒng)計學意義(P0.05);2.兩組的骨水泥彌散類型及其對治療效果的影響:1兩組骨水泥彌散類型構成不同,有統(tǒng)計學意義(P0.05);2各種彌散方式的術前術后的VAS評分比較有顯著差異(P0.05),三種彌散方式對于患者疼痛緩解均起到良好的效果;三種彌散方式緩解患者疼痛程度的比較無顯著差異(P0.05)3三種彌散方式的術前與術后椎體高度壓縮率對比,均有顯著性差異(P0.05);團塊型和混合型高度恢復效果均要大于彌散型(P0.05),而團塊型和混合型對于椎體的高度恢復效果相當(P0.05)。3.編織囊袋組骨水泥滲透發(fā)生率為7.1%,明顯低于PKP組(18.0%),差異有統(tǒng)計學意義(P0.05)。PKP組和編織囊袋組的平均手術時間分別是28.9±1.7min、30.2±1.2min,兩組間比較有統(tǒng)計學意義(P0.05)。結論:1、通過對比兩種手術方式,擴張型編織囊袋椎體成形術在治療椎體骨質(zhì)疏松性壓縮骨折方面具有明顯優(yōu)勢,在解決疼痛、手術時間、骨水泥注入量方面,兩者無差異,在恢復椎體高度、矯正后凸畸形和骨水泥滲漏方面優(yōu)于PKP。2、不同骨水泥分布方式對治療效果的影響:PKP組病例骨水泥彌散多呈彌散型和混合型,囊袋組多成混合型和團塊型,三種彌散方式的緩解患者疼痛程度基本相同,混合型和團塊型的彌散方式在恢復椎體高度較彌散型有一定優(yōu)勢,但在骨水泥及椎體穩(wěn)定方面,彌散型、混合型、彌散型依次減弱。
[Abstract]:Objective: to observe and analyze the clinical effect of percutaneous kyphoplasty (PKP) and braided bag dilatation vertebroplasty in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: one hundred and twenty patients with OVCF received treatment in our hospital from February 2015 to February 2016 were randomly divided into two groups: PKP group (n = 60) and braided bag group (n = 60). The operative time was observed and compared between the two groups. Preoperative and postoperative pain, Cobb angle, postoperative kyphosis correction rate, bone cement distribution, bone cement leakage. To evaluate and compare the clinical effect of percutaneous kyphoplasty (PKP) and braided pouch dilatation vertebroplasty in the treatment of osteoporotic compression fracture of thoracolumbar vertebrae. Results: 1. The (VAS), Cobb angle of postoperative pain visual score in all patients was improved compared with that before operation, and the difference was statistically significant (P0.05). The difference of VAS score after operation in all patients was not statistically significant (P0.05). The rate of posterior vertebral kyphosis correction was better in group P than that in group P (P0.05). 2. Two groups of bone cement dispersion type and its effect on the treatment: 1 the two groups of bone cement dispersion type composition is different, there is statistical significance (P0.05); (2) there was significant difference in VAS scores between different diffusion modes before and after operation (P0.05), and the three diffusion modes had a good effect on pain relief. There was no significant difference in the degree of pain relief between the three diffusion modes (P0.05). There was significant difference in the compression ratio of the three diffusion modes before and after operation (P0.05). The height recovery effect of mass type and mixed type was higher than that of diffuse type (P0.05), while the effect of mass type and mixed type on height recovery of vertebral body was similar (P0.05). The incidence of bone cement penetration in the braided bag group was 7.1, significantly lower than that in the PKP group (18.0%). The difference was statistically significant (P0.05). The average operation time of the). PKP group and the braided bag group was 28.9 鹵1.7 min and 30.2 鹵1.2 min, respectively. There was statistical significance between the two groups (P0.05). Conclusion: 1. By comparing the two operative methods, dilated braided bag vertebroplasty has obvious advantages in the treatment of osteoporotic compression fracture of vertebral body, but there is no difference between them in pain solving, operation time and cement injection. In recovery of vertebral height, correction of kyphosis and leakage of bone cement, the effect of different distribution patterns of bone cement on the treatment effect was better than that of PKP.2,. In PKP group, the dispersion of bone cement was more diffuse and mixed. The degree of pain relief in the three diffusion modes was basically the same. The diffusion mode of mixed and mass type had some advantages in restoring vertebral body height, but in bone cement and vertebral body stability. The dispersion type, the mixed type and the diffuse type are weakened in turn.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3
[Abstract]:Objective: to observe and analyze the clinical effect of percutaneous kyphoplasty (PKP) and braided bag dilatation vertebroplasty in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: one hundred and twenty patients with OVCF received treatment in our hospital from February 2015 to February 2016 were randomly divided into two groups: PKP group (n = 60) and braided bag group (n = 60). The operative time was observed and compared between the two groups. Preoperative and postoperative pain, Cobb angle, postoperative kyphosis correction rate, bone cement distribution, bone cement leakage. To evaluate and compare the clinical effect of percutaneous kyphoplasty (PKP) and braided pouch dilatation vertebroplasty in the treatment of osteoporotic compression fracture of thoracolumbar vertebrae. Results: 1. The (VAS), Cobb angle of postoperative pain visual score in all patients was improved compared with that before operation, and the difference was statistically significant (P0.05). The difference of VAS score after operation in all patients was not statistically significant (P0.05). The rate of posterior vertebral kyphosis correction was better in group P than that in group P (P0.05). 2. Two groups of bone cement dispersion type and its effect on the treatment: 1 the two groups of bone cement dispersion type composition is different, there is statistical significance (P0.05); (2) there was significant difference in VAS scores between different diffusion modes before and after operation (P0.05), and the three diffusion modes had a good effect on pain relief. There was no significant difference in the degree of pain relief between the three diffusion modes (P0.05). There was significant difference in the compression ratio of the three diffusion modes before and after operation (P0.05). The height recovery effect of mass type and mixed type was higher than that of diffuse type (P0.05), while the effect of mass type and mixed type on height recovery of vertebral body was similar (P0.05). The incidence of bone cement penetration in the braided bag group was 7.1, significantly lower than that in the PKP group (18.0%). The difference was statistically significant (P0.05). The average operation time of the). PKP group and the braided bag group was 28.9 鹵1.7 min and 30.2 鹵1.2 min, respectively. There was statistical significance between the two groups (P0.05). Conclusion: 1. By comparing the two operative methods, dilated braided bag vertebroplasty has obvious advantages in the treatment of osteoporotic compression fracture of vertebral body, but there is no difference between them in pain solving, operation time and cement injection. In recovery of vertebral height, correction of kyphosis and leakage of bone cement, the effect of different distribution patterns of bone cement on the treatment effect was better than that of PKP.2,. In PKP group, the dispersion of bone cement was more diffuse and mixed. The degree of pain relief in the three diffusion modes was basically the same. The diffusion mode of mixed and mass type had some advantages in restoring vertebral body height, but in bone cement and vertebral body stability. The dispersion type, the mixed type and the diffuse type are weakened in turn.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3
【參考文獻】
相關期刊論文 前10條
1 楊俊;陳繹志;;經(jīng)皮椎體成形術治療骨質(zhì)疏松性椎體骨折的臨床效果探討[J];醫(yī)學理論與實踐;2016年24期
2 李光輝;劉志軍;段建輝;田鑫;沈勤耀;;PVP治療骨質(zhì)疏松性椎體壓縮性骨折967例近期隨訪研究[J];中國中醫(yī)骨傷科雜志;2016年12期
3 鄺清明;鐘龍岡;;PVP與PKP治療椎體壓縮性骨折140例的療效及對并發(fā)癥的影響[J];上海醫(yī)藥;2016年23期
4 高瓊;郝延科;;編制囊袋椎體后凸成形術治療胸腰椎骨質(zhì)疏松性壓縮骨折12例臨床觀察[J];中國民族民間醫(yī)藥;2016年02期
5 汪呈;曹宇;顧永清;張令強;;骨質(zhì)疏松治療藥物的研究進展[J];科學通報;2014年13期
6 陳學謙;趙繼陽;陳鄭增;王忠偉;李家明;;PVP術與PKP術治療骨質(zhì)疏松性胸腰椎壓縮骨折效果比較[J];現(xiàn)代中西醫(yī)結合雜志;2014年10期
7 王，
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