高粘度与低粘度骨水泥PVP治疗骨质疏松性椎体压缩骨折疗效及安全性分析  

The effect and safety of high-viscosity and low-viscosity bone cement in percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures

作　　者：郭振鹏[1] 尚晖[1] 李小琴[2] 郭晓鹏[1] 岑毕文[1] 邓磊[1] 

机构地区：[1]湖北省十堰市太和医院(湖北医药学院附属医院)骨三科,湖北十堰442000 [2]湖北省十堰市太和医院(湖北医药学院附属医院)普一科,湖北十堰442000

出　　处：《生物骨科材料与临床研究》2016年第2期17-19,23,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的对比较经皮椎体成形术(PVP)中使用高粘度骨水泥与低粘度骨水泥治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效和安全性。方法将68例OVCF行PVP治疗的患者分为高粘度组与低粘度组,分别采用高粘度骨水泥与低粘度骨水泥修复,比较两组患者疼痛缓解(VAS)、脊柱功能改善情况(ODI)、骨水泥渗漏发生率、术后骨水泥肺栓塞发生率及术后邻近椎体骨折发生率情况。结果末次随访,两组VAS、ODI评分均较术前改善,但高粘度组较低粘度组改善更加明显,差异均有统计学意义(<0.01)。高粘度组骨水泥渗漏发生为2.9%,明显低于低粘度组(20.6%),差异有统计学意义(x^2=5.100,<0.05);高粘度组术后骨水泥肺栓塞发生率为0,明显低于低粘度组(11.8%),差异有统计学意义(x^2=4.250,<0.05);高粘度组术后邻近椎体骨折发生率为0,明显低于低粘度组术后邻近椎体骨折发生率(14.7%),差异有统计学意义(x^2=5.397,<0.05)。结论经皮椎体成形术中使用高粘度骨水泥疗效显著,术后并发症少。Objective To compare the clinical effect and safety of high-viscosity and low-viscosity bone cement in PVP for patients with OVCF. Methods 68 patients with OVCF were enrolled in this study. All patients were divided to highviscosity bone cement group and low-viscosity bone cement group. High-viscosity bone cement group used the high viscosity PMMA, low-viscosity bone cement group used the low-viscosity PMMA. The pain relief, spinal function improvement, the bone cement leakage rate, the incidence of bone cement pulmonary emblism after operation, the postoperative incidence of adjacent vertebral fractures was detected between the two groups. Results Last follow-up showed all patients got improvement in VAS, ODI score. It was superior to the low-viscosity bone cement group in the VAS, ODI score.The bone cement leakage rate in the high-viscosity group was significantly lower than that in the low-viscosity group（2.9%vs20.6%, x^2=5.100, P〈0.05 ）. The incidence of bone cement pulmonary emblism after operation in the high-viscosity group was significantly lower than that in the low-viscosity group（0% vs 11.8%, x^2=4.250, P〈0.05 ）. The postoperative incidence of adjacent vertebral fractures in the high-viscosity group was significantly lower than that in the low- viscosity group（0%vs14.7%, x^2=5.397, P〈0.05 ）. Conclusion The clinical effect of high-viscosity bone cement treatment of vertebral compression fractures are obviously with a low incidence of the complication.

关 键 词：高粘度骨水泥 低粘度骨水泥 椎体骨折 骨质疏松 椎体成形术 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]