【摘要】：背景椎體成形術(shù)和球囊擴(kuò)張后凸成形術(shù)是兩種治療骨質(zhì)疏松性骨折的經(jīng)典微創(chuàng)手術(shù)方式,而近些年來關(guān)于兩種手術(shù)方式的手術(shù)效果和并發(fā)癥方面的爭議一直存在。方法在數(shù)據(jù)庫中檢索關(guān)于對比椎體成形術(shù)和球囊擴(kuò)張后凸成形術(shù)治療骨質(zhì)疏松性椎體骨折的手術(shù)效果和并發(fā)癥方面的文獻(xiàn),包括隨機(jī)對照實(shí)驗(yàn)、臨床對照實(shí)驗(yàn)以及隊(duì)列分析。提取基本信息、臨床數(shù)據(jù)、影像學(xué)數(shù)據(jù)、并發(fā)癥分析進(jìn)行薈萃分析。結(jié)果共21項(xiàng)研究,1713名患者的數(shù)據(jù)資料納入研究分析,其中椎體成形組869人,球囊擴(kuò)張后凸成形組844人,兩組患者的疼痛評分近遠(yuǎn)期效果無差異,椎體成形術(shù)組手術(shù)所需時間更少,球囊擴(kuò)張后凸成形術(shù)組能更好地恢復(fù)傷椎的高度和矯正后凸畸形。從并發(fā)癥看,骨水泥向椎間盤滲漏的概率兩個手術(shù)組沒有差異,但是總的骨水泥滲漏率和椎旁骨水泥滲漏率球囊擴(kuò)張后凸成形術(shù)的發(fā)生率更低。結(jié)論椎體成形術(shù)和球囊擴(kuò)張后凸成形術(shù)都能有效緩解臨床癥狀,但椎體成形手術(shù)時間更短,因此,對于不能忍受長時間的手術(shù)的患者而言可能更適合選擇椎體成形手術(shù)。但球囊擴(kuò)張后凸成形術(shù)在恢復(fù)椎體的高度和矯正后凸畸形方面更具有優(yōu)勢,而且骨水泥發(fā)生滲漏的概率更低,對于那些椎體高度丟失明顯、嚴(yán)重后凸畸形的患者,球囊后凸成形術(shù)可能是更安全的選擇。此外,椎體成形術(shù)更高的骨水泥滲漏概率可能主要是由于椎旁滲漏更高引起的。
[Abstract]:Background Vertebroplasty and balloon dilated kyphoplasty are two classical minimally invasive methods for the treatment of osteoporotic fractures, but in recent years there has been controversy about the effects and complications of the two methods. Methods in the database, we searched the literature about the effects and complications of vertebroplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral fractures, including randomized controlled trials, clinical controlled trials and cohort analysis. Extraction of basic information, clinical data, imaging data, complications analysis for meta-analysis. Results A total of 21 studies were conducted. The data of 1713 patients were included in the study. There were 869 patients in vertebroplasty group and 844 patients in balloon dilated kyphoplasty group. There was no significant difference in pain scores between the two groups. The operation time of vertebroplasty group was less. Balloon dilated kyphoplasty group could recover the height of injured vertebra and correct kyphosis better. There was no difference in the probability of bone cement leakage to intervertebral disc between the two groups from complications, but the overall bone cement leakage rate and paravertebral cement leakage rate were lower in balloon dilated kyphoplasty. Conclusion both vertebroplasty and balloon kyphoplasty can effectively relieve the clinical symptoms, but the time of vertebroplasty is shorter. Therefore, vertebroplasty may be more suitable for patients who cannot endure long-term surgery. But balloon dilated kyphoplasty has the advantage in restoring the height of vertebral body and correcting kyphosis deformity, and the probability of bone cement leakage is lower. For those patients whose vertebral body height is lost obviously and severe kyphosis deformity, Balloon kyphoplasty may be a safer option. In addition, the higher probability of bone cement leakage in vertebroplasty may be mainly due to higher paravertebral leakage.
【學(xué)位授予單位】：揚(yáng)州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 袁文;謝寧;;椎體成形術(shù)與后凸成形術(shù)的臨床應(yīng)用及相關(guān)問題[J];中國骨傷;2010年10期

2 傅建淞;莊新明;付長峰;曲志剛;姜亦坤;劉一;;球囊擴(kuò)張后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的療效及安全性評價[J];吉林大學(xué)學(xué)報(醫(yī)學(xué)版);2012年05期

3 葉添文,賈連順;后凸成形術(shù)應(yīng)用于骨質(zhì)疏松性椎體壓縮性骨折的現(xiàn)狀[J];中國脊柱脊髓雜志;2002年04期

4 許明嫻;經(jīng)皮后凸成形術(shù)的手術(shù)配合2例[J];中國實(shí)用護(hù)理雜志;2005年02期

5 顧曉暉;楊惠林;張U，

本文編號：2441857