多节同时穿刺与逐节穿刺椎体成形术治疗多椎体骨质疏松性骨折的疗效比较  

More Section and Puncture and Section by Puncture Vertebral Plasty Treatment the Curative Effect of Vertebral Osteoporotic Fracture

作　　者：王多军[1] 刘晓东[1] 蔡丰[1] 刘亮[1] 杨安礼[1] 

机构地区：[1]同济大学附属杨浦医院骨科,上海杨浦区200090

出　　处：《河北医学》2017年第3期446-449,共4页Hebei Medicine

基　　金：国家自然科学基金项目;(编号:81372105);上海市科委产学研科研项目;(编号:15DZ1942603)

摘　　要：目的:探究多节同时穿刺与逐节穿刺椎体成形术(PVP)治疗多椎体骨质疏松性骨折的疗效比较。方法:选取2009年1月至2016年1月期间经PVP治疗多椎体骨质疏松压缩性骨折患者120例(262节椎体),随机分为观察组60例(134椎)和对照组60例(128椎),对照组予以逐节穿刺入路,观察组予以多节同时穿刺入路,观察对比两组疼痛程度、伤椎功能恢复、平均单个伤椎手术时间、手术安全性等指标。结果:两组术后次日VAS疼痛评分、ODI评分均低于术前(P<0.05),两组术后次日的VAS评分、ODO评分比较无显著差异(P>0.05)。观察组平均单个伤椎手术时间、平均单个伤椎透视次数均少于对照组(P<0.05);两组平均单个伤椎骨水泥注射剂量比较无显著差异(P>0.05)。观察组骨水泥渗漏发生率为13.3%,对照组骨水泥渗漏发生率为16.7%,两组比较无显著差异(P>0.05)。结论:对非严重的椎体塌陷者,多节同时穿刺入路行PVP治疗多椎体骨质疏松性骨折可取得常规逐节入路PVP相似的临床疗效,且可缩短手术时间和透视时间,且手术安全性较高。Objective： To explore the multi section and puncture and by puncture vertebral plasty（ PVP） treatment the curative effect of vertebral osteoporotic fracture. Selection Methods： From January 2009 to January 2016,our hospital during the period of the PVP treatment of more than 120 patients with vertebral osteoporosis compression fractures（ 262 knots） vertebral bodies,60 cases were divided into observation group（ 134 vertebral） and the control group 60 cases（ 128 vertebral）,the control shall be by piercing into the road,observation group s to puncture into the road at the same time,compared two groups of pain degree,injured vertebral function recovery,average single vertebral operation time,security measures such as surgery.Results： Two groups of postoperative VAS pain score the next day and ODI scores were lower than the preoperative（ P 〈 0.05）,two groups of postoperative the ODO VAS score,score was no significant difference（ P 〉0.05）.Observation group average single wounded vertebral operation time,average single vertebral perspective times are less than the control group（ P 〈 0.05）; Two groups of average single injured vertebrae cement injection dose was no significant difference（ P 〉 0.05）.Observation group of bone cement leakage rate was 13.3%,the control group in the incidence of leakage of bone cement was 16.7%,comparing the two groups had no significant difference（ P 〉 0.05）. Conclusion： For severe vertebral body collapse,multiple class and piercing into the road line PVP treatment vertebral osteoporotic fractures can be obtained more regular by section in the PVP similar clinical curative effect,and can shorten the operation time and the time perspective,and safe operation.

关 键 词：多节同时穿刺 逐节穿刺 椎体成形术 多椎体骨质疏松性骨折 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]