PVP/PKP联合唑来膦酸治疗胸腰椎骨质疏松性椎体压缩性骨折的效果  

Effect of PVP/PKP Combined with Zoledronic Acid in the Treatment of Thoracolumbar Osteoporotic Compression Fractures

作　　者：陈昱[1,2] 林世水[1,2] 邱美光[1,2] 詹儒东 刘国铭[1,2] 胡旭[1,2] 李建华 高尚君 周仕国[1,2] CHEN Yu;LIN Shi-shui;QIU Mei-guang;ZHAN Ru-dong;LIU Guo-ming;HU Xu;LI Jian-hua;GAO Shang-jun;ZHOU Shi-guo(Provincial Clinical Medical College of Fujian Medical University,Fujian Fuzhou 350001;South Hospital of Fujian Provincial Hospital,Fujian Fuzhou 350028)

机构地区：[1]福建医科大学省立临床医学院,福建福州350001 [2]福建省立医院南院,福建福州350028

出　　处：《深圳中西医结合杂志》2022年第18期24-27,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:分析经皮椎体成形术(PVP)/球囊扩张椎体后凸成形术(PKP)与唑来膦酸联合在胸腰椎骨质疏松性椎体压缩性骨折(OVCF)患者治疗中的应用价值。方法:选取2019年5月至2021年5月于福建省立医院南院治疗的62例胸腰椎OVCF患者,随机数字表法将患者分为观察组和对照组,每组各31例。对照组实施PVP/PKP,观察组于对照组基础上术后给予唑来膦酸静脉滴注,比较两组患者术前及术后3个月、6个月Cobb角和椎体前缘高度,视觉模拟评分法(VAS)评分、Oswestry功能障碍指数问卷表(ODI)评分、血清骨碱性磷酸酶(BALP)、Ⅰ型胶原C端肽(CTX-1)、椎体骨密度(BMD),治疗结束后随访1年再骨折情况。结果:观察组患者术后3个月、6个月Cobb角均小于对照组,伤椎前缘高度均高于对照组,差异具有统计学意义(P<0.05);两组患者术后3个月、6个月VAS、ODI较术前降低,且观察组患者均低于对照组,差异具有统计学意义(P<0.05);观察组患者术后3个月、6个月的BALP、CTX-1水平低于对照组,BMD高于对照组,差异具有统计学意义(P<0.05)。结论:PVP/PKP联合唑来膦酸治疗OVCF能缓解术后疼痛,改善椎体功能,调节骨代谢,提高骨密度,减少骨折再发生。Objective To analyze the application value of percutaneous vertebroplasty(PVP)/percutaneous kyphoplasty(PKP)combined with zoledronic acid in the treatment of patients with thoracolumbar osteoporotic vertebral compression fracture(OVCF).Methods A total of 62 patients with thoracolumbar OVCF admitted to the South Hospital of Fujian Provincial Hospital from May 2019 to May 2021 were selected and divided into an observation group and a control group by random number table method,with 31 cases in each group.The control group was treated with PVP/PKP,and the observation group was treated with zoledronic acid intravenous drip after operation on the basis of the control group.The Cobb angle and anterior vertebral height,the scores of visual analogue scale(VAS)and Oswestry dability index(ODI),serum bone alkaline phosphatase(BALP),C-telopeptide of type1(CTX-1),vertebral bone mineral density(BMD)of the two groups were compared before and after operation 3 months and 6 months,and refracture rate were measured at 1 year after treatment.Results The Cobb angles of the observation group at 3 months and 6 months after operation were lower than those of the control group,and the anterior height of the injured vertebra was higher than that of the control group,and the differences were statistically significant(P<0.05).The scores of VAS and ODI of the two groups at 3 months and 6 months after operation were lower than those before operation,the scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The levels of BALP and CTX-1 of the observation group at 3 and 6 months after operation were lower than those of the control group,and the BMD was higher than that of the control group,and the differences were statistically significant(P<0.05).Conclusion PVP/PKP combined with zoledronic acid in the treatment of OVCF can relieve postoperative pain,improve vertebral function,regulate bone metabolism,increase bone mineral density and reduce the occurrence of refra

关 键 词：骨质疏松性椎体压缩性骨折 球囊扩张椎体后凸成形术 经皮椎体成形术 唑来膦酸 

分 类 号：R687.3[医药卫生—骨科学]