防腐标本椎体成形术中生理盐水灌洗对骨水泥注射压力、分布、外渗的影响  

Effect of pulsed normal saline lavage on the injection force, distribution, and leakage of bone cement in vertebroplasty of embalmed vertebral body

作　　者：康乐[1] 齐向北[1] 黄晨[1] 高守达 桑林朝 

机构地区：[1]河北医科大学第三医院骨科河北省骨科生物力学重点实验室,石家庄050051

出　　处：《中华实验外科杂志》2014年第1期124-126,共3页Chinese Journal of Experimental Surgery

基　　金：河北省自然科学基金资助项目（H2012206068）

摘　　要：目的 探讨生理盐水脉冲式灌洗对椎体成形术中骨水泥分布、注射压力、外渗的影响.方法 选用40个防624D腐标本椎体,经处理后制备成压缩骨折模型.将其随机均分成两组,实验组在进行椎体成形术之前,运用200 ml生理盐水脉冲式灌洗椎体,对照组不进行灌洗.所有样本都将3ml中黏度骨水泥注入椎体,同时对注射压力、骨水泥的分布和外渗进行测定.结果 应用K-W检验对两组注射压力进行比较,显示：对照组压力60％在100N以上,而实验组仅15％在100N以上,差异有统计学意义（P＜0.05）；骨水泥分布,CT显示：实验组分布更加均匀；骨水泥外渗：对照组为40％ （8/20）椎体出现外渗,而实验组为15％ （3/20）.结论 在椎体成形术中,预先应用生理盐水脉冲式灌洗,可以使骨水泥分布更加均匀,同时降低了骨水泥外渗及肺栓塞的发生率,使骨水泥注入更加安全.Objective To investigate the effect of the pulsed lavage on the injection pressure and the distribution and the leakage of bone cement for the vertebroplasty.Methods The compression fracture was modeled on forty embalmed verteboral body that were divided into the control group and the experimental group.3 ml medium viscosity bone cement was infused into all the vertebral bodies and the pulsed lavage was used before the injection of bone comment on the experimental group.The injection force,distribution and leakage of bone cement were exmanined.Results All the normal saline was recycled due to the application of negative pressure devices.K-W test was used for the comparison between the experimental group and the control group.It was shown that the injection pressure of bone cement with more than 100 N was 60% and 15% in the control group and the experimental group,respectively.P 〈0.05 was considered significantly different.The CT result showed that the distribution of bone cement was more well-distributed,The rate of extravasation was 40% （8/20） and 15% （3/20） in the control group and the experimental group,respectively.Conclusion The pulsed lavage is benefit to the uniform distribution of bone comment and reduce the leakage of bone cement and the the incidence of pulmonary embolism for vertebroplasty.

关 键 词：椎体成形术 灌洗 注射压力 骨水泥分布 骨水泥外渗 

分 类 号：R687.3[医药卫生—骨科学]