椎体成形术临床应用1080例  

Clinical application of vertebroplasty： a report of 1080 cases

作　　者：桑林朝 康乐[1] 黄晨[1] 高守达 李军科[1] 黄习彬 齐向北[1] 

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

出　　处：《中华创伤杂志》2014年第11期1117-1121,共5页Chinese Journal of Trauma

基　　金：河北省自然科学基金资助项目（H2012206068）

摘　　要：目的 收集行椎体成形术患者相关临床资料,分析该术式的临床应用情况,以使该术式能够更好地服务于临床患者.方法 回顾性分析2003年1月-2012年3月1084例椎体成形术患者的临床资料,其中资料完整且符合要求的患者为1 080例,分析年龄、性别、病种、手术的椎体数目、手术椎体的分布、术后X线片、注入椎体骨水泥的量、椎管内骨水泥渗漏率、骨水泥渗漏到椎体外的渗漏率、经球囊撑开与否的患者例数、行单双侧椎体成形术患者的例数、手术过程中患者的生命体征等基本资料12项,并且着重收录、分析、观察患者术后的临床表现,随访患者术后的生活质量.结果 在1 080例患者中,术后X线片发现骨水泥渗漏者306例,占28.33％;注入骨水泥的量为1.5 ～ 7.5 ml;术中未发现椎管内渗漏;经球囊撑开的患者达706例,占65.37％;行单侧椎体成形术的患者达984例,占91.11％.23例患者在术后3～5 d内出现相关的临床症状,其中3例出现神经症状;其余20例出现与肺栓塞相关的临床症状,男5例,女15例,1例因肺栓塞症状严重转入呼吸内科进行治疗;单椎体手术8例,双椎体手术15例;涉及胸椎手术17例.结论 椎体成形术虽然有各种临床并发症,但是掌握正确的手术方法及严格的手术适应证,此术式应在临床积极开展.Objective To analyze the efficacy of vertebroplasty using the patient data in our hospital so as to better serve those clinical patients.Methods A retrospectively review was performed on 1 080 with data integrity out of 1 084 cases undergone vertebroplasty from January 2003 to March 2012.Basic information measured was age,gender,entity,number of operated vertebral bodies,distribution of operated vertebral bodies,postoperative X-ray films,bone cement volume,bone cement leakage into the vertebral canal,cases with balloon kyphoplasty,cases with bilateral or bilateral vertebroplasty,and intraoperative vital signs.Clinical manifestations and quality of life were observed after operation.Results In all,306 cases occupying 28.33% presented bone cement leaks based on postoperative X-ray films.Volume of bone cement infused in each vertebral body varied from 1.5 ml to 7.5 ml.No bone cement leaked into the vertebral canal during operation.There were 706 cases occupying 65.37% managed by balloon kyphoplasty and 984 cases occupying 91.11% by unilateral vertebroplasty.Within 3-5 days after surgery,associated symptoms were found in 23 cases,among which 3 had neurologic symptoms and 20 composing 5 men and 15 women had symptoms related to pulmonary embolism including one severely affected was transferred to the department of pneumology.Among the 23 cases,8 were managed by unilateral vertebroplasty and 15 by bilateral vertebroplasty,including 17 involving thoracic surgery.Conclusion Although various complications relate to the procedure,vertebroplasty may be widely used on condition that techniques and indications iu surgery are correctly mastered.

关 键 词：椎体成形术 肺栓塞 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]