PKP治疗骨质疏松性多节段椎体压缩性骨折的临床疗效  

Therapeutic effect of percutaneous kyphoplasty on osteoporotic multi-compressive fracture

作　　者：樊庆凯 龚维明[1] 宁斌[1] 宋宏亮[1] 蔚建鲁[1] 贾堂宏[1] 

机构地区：[1]山东大学附属济南市中心医院骨科,山东济南250013

出　　处：《山东大学学报（医学版）》2014年第11期73-76,91,共5页Journal of Shandong University:Health Sciences

基　　金：济南市科技局科技发展计划(201019001);济南市卫生局科技计划(2011-27)

摘　　要：目的：观察与评价经皮穿刺椎体后凸成形术（PKP）治疗多节段骨质疏松性椎体压缩性骨折（OVCF）的临床疗效。方法2009年1月至2013年12月多节段OVCF患者68例，其中17例（共49椎体）为保守组，行绝对卧床保守治疗，51例（共121椎体）为手术组，接受PKP手术治疗，两组患者均行同样的抗骨质疏松治疗。两组患者通过临床及影像学资料，采用Barthel指数、Cobb角测量、模拟视觉评分（VAS）及Oswesty功能障碍指数（ODI），评价两组临床效果差异，评估PKP的治疗效果。结果68例患者获随访12～24个月（平均18．6月），手术组术后24 h内疼痛症状均有明显缓解或消失。X线片示椎体高度未见明显丢失，未出现严重并发症。手术组在Barthel指数、Cobb角测量、VAS评分及ODI指数的效果评分中，术前与术后3 d、入院后3个月、入院后12个月相比，效果差异较大（P＜0．05）；手术组与保守组1年后相比，Cobb角测量也同样存在较大的差异（P＜0．05）；而Barthel指数、VAS评分及ODI指数差异性较小（P＞0．05）。结论 PKP是多节段骨质疏松性椎体压缩性骨折的有效治疗方法，可靠性和安全性较高，具有较高的临床价值。Objective To observe and evaluate the therapeutic effect of percutaneous kyphoplasty （PKP）on osteopo-rotic multi-compressive fracture （OVCF）.Methods A retrospective study was conducted on 68 OVCF cases during Jan.2009 to Dec.2013.The control group （n =17,9 vertebrae）was treated with strict-in-bed method,while the surgical group （n=51,121 vertebrae）was treated with PKP.In addition,the two groups received the same anti-osteo-porosis treatment.The clinical and radiological parameters of the two groups were compared,including Barthel index, Cobb angle,visual analogue scale/score （VAS）and Oswesty disability index （ODI）.Results After a follow-up of 12~24 months （average 18.6 months）,the data indicated that the pain of 51 cases was significantly released or even eradicated 24 hours after surgery.X-ray images showed no obvious bone loss or severe complications.There was signif-icant statistic difference （P〈0.05）in Barthel Index,Cobb angle,VAS and ODI in the surgical group before and 12 months after the PKP surgery.There was marked difference （P〈0.05）between the surgical group and control group in Cobb Angle one year after PKP surgery （P〈0.05）.Conclusion PKP is safe and effective to treat osteoporotic multi-Compressive fracture.

关 键 词：经皮穿刺椎体后凸成形术 骨质疏松性椎体压缩性骨折 临床疗效 

分 类 号：R683.2[医药卫生—骨科学]