经皮椎体成形术与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效比较研究  

Comparison of PVP with Conservative Therapy in Treatment of Elderly Osteoporotic Thoracolumbar Vertebral Compression Fracture

作　　者：杜浩[1] 田笑笑[2] 张晓强[3] 李同森[1] 常彦卿[1] 赵大治[1] 

机构地区：[1]河南科技大学第一附属医院骨科,河南省洛阳市471003 [2]河南科技大学第一附属医院消化内科,河南省洛阳市471003 [3]河南省洛阳正骨医院

出　　处：《中国全科医学》2013年第14期1629-1632,共4页Chinese General Practice

基　　金：洛阳市科技发展计划项目(1201051A-4)

摘　　要：目的比较经皮椎体成形术(PVP)与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效。方法选择2009年7月—2010年10月我院收治的老年骨质疏松性胸腰椎压缩骨折患者38例,采用随机数字表法并结合患者自身要求分为对照组(17例)和治疗组(21例),分别采用保守法和PVP进行治疗。比较两组患者治疗前后疼痛视觉模拟评分(VAS评分)、椎体高度及Cobb角、椎体再骨折情况。结果对照组和治疗组组内治疗前、治疗后1周、治疗后1个月、末次随访时VAS评分比较,差异均有统计学意义(P<0.05);组间同期比较,仅治疗后1周时VAS评分差异有统计学意义(P<0.05)。两组患者治疗前椎体前缘、中线、后缘高度及Cobb角比较,差异均无统计学意义(P>0.05);治疗后比较,除椎体后缘高度外,其他指标间差异均有统计学意义(P<0.05)。对照组治疗前后椎体前缘、中线高度及Cobb角比较,差异均有统计学意义(P<0.05);椎体后缘高度比较,差异无统计学意义(P>0.05)。治疗组治疗前后椎体前缘、中线、后缘高度及Cobb角比较,差异均无统计学意义(P>0.05)。对照组有2例、治疗组有4例患者出现椎体再骨折。结论 PVP止痛效果显著且持久,但较难恢复椎体高度,术后椎体再骨折发生率较高;保守法治疗止痛周期较长,椎体高度恢复情况较好,术后椎体再骨折发生率较低。Objective To compare the clinical effect of percutaneous vertebroplasty （PVP） with that of conservative therapy in treatment of elderly osteoporotic thoracolumbar vertebral compression fractures. Methods A total of 38 elderly osteo- porotic patients with thoracolumbar vertebral compression fracture admitted from July 2009 to October 2010 were divided randomly into groups control （n =17, given conservative therapy） and therapy （n =21, given PVP）. The visual analog scale （VAS） , vertebral height and Cobb＇s angle, vertebral refracture occurrence were compared in 2 groups before and after treatment. Results There was significant difference in VAS between 2 groups before treatment, 1 week and 1 month after treatment, during the last follow - up （P 〈 0. 05）, and between groups in the same period 1 week after treatment （P 〈 0.05 ）. No difference was not- ed in heights of vertebral anterior, midline , posterior borders or Cobb＇s angle between 2 groups before treatment （P 〉 0.05 ）, but there was except in height of vertebral posterior border after treatment （ P 〈 0.05 ）. There was difference in height of verte- bral anterior, midline borders and Cobb＇s between pre - and post - treatment in control group （P 〈 0. 05）, but there was no in vertebral anterior border height （P 〉 0. 05）. There was no difference in height of anterior, midline, posterior or Cobb＇s angle between pre - and post - treatment in therapy group （ P 〉 0. 05 ）. Two from control group, 4 from therapy group had vertebral refractures. Conclusion PVP has remarkable and lasting analgesic effect but is more difficult to restore vertebral height with higher incidence of refractures ; Conservative therapy has longer analgesic effect and vertebral height recovered better with lower incidence of vertebral refractures after treatment.

关 键 词：椎体成形术 老年人 骨质疏松 骨折 压缩性 

分 类 号：R683.2[医药卫生—骨科学]