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作 者:陈书连[1] 张广泉[1] 高坤[1] 郑稼[1] 高延征[1] 王义生[2]
机构地区:[1]河南省人民医院骨科,郑州市450003 [2]郑州大学第一附属医院骨科
出 处:《中华实用诊断与治疗杂志》2009年第10期953-956,共4页Journal of Chinese Practical Diagnosis and Therapy
基 金:人事部留学人员科技项目择优资助经费项目(2007);河南省医学科学院创新人才工程资助项目;医学科技重大公关资助项目(2002305);河南省医学科技重点攻关项目(200702011)
摘 要:目的:探讨经皮椎体成形术和椎体后凸成型术治疗骨质疏松性椎体压缩性骨折的效果及并发症的防治策略。方法:单纯性骨质疏松性压缩性椎体骨折患者37例(60个椎体),随机分为经皮椎体成形术组18例25个椎体,椎体后凸成型术组19例35个椎体。比较2组手术前1d,手术后1d,1周,4周,8周,12周和24周测定疼痛视觉模拟评分和患者满意程度,测定后凸矫正率,观察骨水泥渗漏率。结果:2组疼痛视觉模拟评分均较手术前明显下降(P<0.01),2组间差异无统计学意义(P>0.05);手术后1d,1周,4周,经皮椎体成形术组和椎体后凸成型术组的满意率比较差异无统计学意义(P>0.05)。后凸畸形矫正率,经皮椎体成形术组和椎体后凸成型术组分别为(65.50±3.15)%和(67.83±4.24)%,2组比较差异无统计学意义(P>0.05)。骨水泥渗漏率经皮椎体成形术组为44.00%,椎体后凸成型术组为14.29%,2组间比较差异有统计学意义(P<0.01)。结论:经皮椎体成形术和椎体后凸成型术治疗原理相同、疗效无明显差异;经皮椎体成形术操作相对简单,费用低廉,但骨水泥渗漏发生率较高;椎体后凸成型术可降低骨水泥渗漏的风险,但费用较高。椎体骨折时间较短时(<3个月)宜优先选择椎体后凸成型术,骨折时间较长时优先选择经皮椎体成形术。Objective To evaluate the therapeutic effect of percutaneous vertebroplasty and kyphoplasty for the treatment of osteoporotic vertebral compression fractures and the prevention of complications.Methods Thirty-seven patients(60 vertebral fractures)were treated with percutaneous vertebroplasty(18 patients,25 vertebral fractures)or percutaneous kyphoplasty(19 patients,35 vertebral fractures).All patients were observed VAS scales and patients satisfactory degrees 1 day before operation,1 day,1 week,4 weeks,8 weeks,12 weeks and 24 weeks after operation.The restorations of kyphosis was determined and cement leakage was observed.Results Postoperative VAS scales of all patients reduced obviously after operation(P0.01),and there was no statistic difference between two groups(P0.05).The restoration rates of kyphosis were(65.50±3.15)% and(67.83±4.24)% in two groups,with no statistic difference between two groups(P0.05).All patients were satisfied with these treatments,but no statistic difference between two groups(P0.05)in 1 day,1 week and 4 weeks after operation.The rate of cement leakage was significant higher in the percutaneous vertebroplasty group(44.00%)than that in the percutaneous kyphoplasty group(14.29%)(P0.01).Conclusion Both percutaneous vertebroplasty and kyphoplasty can effectively relieve the back pain.Percutaneous vertebroplasty is superior to percutaneous kyphoplasty in the prevention of cement leakage.
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