经皮椎体球囊扩张成形术不同手术时机对胸腰椎骨质疏松性压缩性骨折疗效的影响  

Effect of percutaneous vertebral balloon angioplasty in treatment of osteoporotic compression fracture of thoracic and lumbar vertebrae at different operation time

作　　者：杨俊龙[1] 刘志祥[1] 赖震[1] 张兆飞[1] 

机构地区：[1]南方医科大学附属花都医院,广州510800

出　　处：《创伤外科杂志》2017年第7期484-487,共4页Journal of Traumatic Surgery

摘　　要：目的研究调查手术时机选择对行经皮椎体球囊扩张成形术(PKP)治疗胸腰椎骨质疏松性压缩性骨折(OVCF)的效果影响。方法以2012年8月~2015年8月南方医科大学附属花都医院收治的65例OVCF患者为研究对象,根据受伤至手术时间将患者分成三组:A组23例,手术时间在骨折后1周之内;B组21例,手术时间在骨折后1~2周;C组21例,手术时间在骨折后2~4周。比较三组患者VAS评分、Cobb角、伤椎再骨折、骨水泥渗漏等相关数值以及变化情况。结果术前三组患者的VAS评分无明显差异(P>0.05),而出院时的VAS评分随着手术的延后分值越高而改善率越低;手术后椎体前缘高度恢复值以及Cobb角改善率则均随着手术的延后逐渐减小,差异具有统计学意义(P<0.05);A组手术优良率明显高于B组和C组,差异均有统计学意义(P<0.05),伤椎再骨折A组2例、B组1例、C组无,骨水泥渗漏A组4例、B组3例、C组1例。结论早期采用PKP治疗胸腰椎骨质疏松性压缩性骨折可以有效减轻患者疼痛,促进恢复,对其生活质量的提高意义显著。Objective To explore the effect of percutaneous vertebral balloon angioplasty in treatment of osteoporotic compression fracture of thoracic and lumbar vertebrae （ OVCFs ） at different operation time. Methods Sixty-five patients with OVCFs treated in the Huadu Hospital Affiliated to Southern Medical University from Aug. 2012 to Aug. 2015 were selected and were divided into group A（ 23 cases ,operation time was within one week after injury） ,group B（21 cases,operation time was at 1-2 weeks after injury） and group C（21 cases,operation time was at 2-4 weeks after injury）. The VAS score, Cobb angles,re-fracture cases and bone cement leakage were compared among the three groups. Results There was no significant difference in VAS scores among the three groups （ P 〉 0. 05 ）. At discharge, the VAS score was higher with the longer delayed operation time, and the improvement rate was poorer （ P 〈 0. 05 ）. The vertebral height recovery and Cobb angles improvement rates of Cobb angles were lower with the longer delayed operation time （ P 〈 0. 05 ）. The excellent and good rate of operation of group A was higher than those of group B and C （ P 〈 0. 05 ）. There were 2 cases of re-fracture in group A, 1 case in group B, and none in group C. Bone cement leakage occurred in 4 cases in group A ,3 cases in group B and 1 case in group C. Conclusion As for OVCFs, percutaneous vertebral balloon angioplasty in early stage can relieve pain and promote recovery.

关 键 词：胸腰椎骨折 椎体骨折 骨质疏松 经皮椎体球囊 扩张术 手术时机 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]