经皮穿刺椎体成形术联合鲑鱼降钙素治疗老年骨质疏松性脊柱压缩骨折的疗效分析  

Efficacy of percutaneous puncture vertebral plasty and salcitonin for old patients with osteoporotic vertebral compression fractures

作　　者：王叶新[1] 孟纯阳[1] 李庆伟[1] 孔祥清[1] 张卫红[1] 

机构地区：[1]济宁医学院附属医院脊柱外科,山东济宁272000

出　　处：《保健医学研究与实践》2017年第4期45-48,共4页Health Medicine Research and Practice

基　　金：山东省医药卫生科技发展项目(2015WS0412)

摘　　要：目的探讨经皮穿刺椎体成形术(PVP)联合鲑鱼降钙素治疗老年骨质疏松性脊柱压缩骨折(OVCF)的疗效。方法选取2014年11月-2017年4月济宁市某医院收治的87例老年OVCF患者为研究对象,所有患者均行PVP,术后服用鲑鱼降钙素6个月。比较患者术前、术后2d时、术后6个月时椎体高度、后凸角及疼痛视觉模拟评分法(VAS)评分、Oswestry功能障碍(ODI)指数、活动能力评分,同时比较患者手术前与手术6个月时的骨密度(BMD)。结果本研究中,患者术后2d及术后6个月时的椎体前壁高度、椎体中间高度均大于术前,椎体前壁高度压缩率、椎体中间高度压缩率、椎体后壁高度压缩率均小于术前,差异均有统计学意义(P<0.05),但患者术后6个月时的椎体前壁高度、椎体中间高度及椎体前壁高度压缩率、椎体中间高度压缩率、椎体后壁高度压缩率与术后2d时比较,差异均无统计学意义(P>0.05)。患者术后2d及术后6个月时的椎体后凸角均小于术前,差异均有统计学意义(P<0.05),但患者术后6个月时的椎体后凸角与术后2d时比较,差异无统计学意义(P>0.05)。患者术后2d及术后6个月时的VAS评分低于术前、活动能力评分高于术前,差异均有统计学意义(P<0.05);患者术后2d及术后6个月时的ODI指数均低于术前,且术后6个月时的ODI指数低于术后2d时,差异均有统计学意义(P<0.05)。患者术后6个月时的腰椎BMD为(0.78±0.08)g/cm^2,高于术前的(0.66±0.02)g/cm^2,差异有统计学意义(P<0.05)。结论 PVP联合鲑鱼降钙素治疗OVCF效果显著,能有效缓解患者疼痛,值得临床推广。Objective To investigate and discuss the efficacy of puncture vertebral plasty（PVP）and salcitonin for osteoporotic vertebral compression fractures（OVCF）in old patients.Methods 87 old patients with OVCF were selected during Nov.2014 to Apr.2017 from a hospital in Jining as objects and all the patients were taken salcition for 6months after PVP.The heights of pathologic vertebral,kyphotic angle,Visual Analogue Scale（VAS）,Oswestry Disfunction Index（ODI）and Activities of Daily Life（ADL）and were compared before the plasty,2dafter the plasty and at the time of last follow-up.Meanwhile the bone mineral densities（BMD）of patients were compared before the plasty and 6months after the plasty.Results In this study 2dafter the plasty and 6months after the plasty the anterior vertebral heights,inter vertebral heights were both higher after the plasty,and the compression ratios of anterior vertebral height,inter vertebral height and posterior vertebral height were lower after the plasty,showing significant statistical difference（P〈0.05）,but when compared the compression ratios of anterior vertebral height,inter vertebral height and posterior vertebral height of patients at the time of 6months after the plasty with the height 2dafter the plasty,there was no statistical significance（P〈0.05）.The kyphotic angle of patients was smaller after the plasty when the plasty ended 2dand 6months,and the difference was statistical significant（P〈0.05）,while comparing the kyphotic angle of patients at the time of 6months after the plasty with the height of 2dafter the plasty,showing no significant statistical difference（P〈0.05）.When the plasty ended 2dand 6 months,the VAS was lower and the ADL was higher,and the differences were statistical significant（P〈0.05）;When the plasty ended 2dand 6months,the ODI was lower and the former was higher,and the differences were statistical significant（P〈0.05）.The BDM of lumbar vertebra was（0.78±0.08）g/cm^2,higher than the（0.66±0.02）g/cm^2

关 键 词：骨质疏松 椎体骨折 经皮穿刺椎体成形术 骨水泥 鲑鱼降钙素 

分 类 号：R687.3[医药卫生—骨科学]