明胶海绵封堵在单侧穿刺经皮椎体后凸成形术的应用  

Application of gelatin sponge plugging in unilateral puncture percutaneous kyphoplasty

作　　者：王开明[1] 杨德顺[1] 廖亮[1] 雷丙俊[1] 秦骥[1] 张庆[1] 杨志勇[1] 

机构地区：[1]安徽省蚌埠市第三人民医院骨科,233000

出　　处：《淮海医药》2017年第5期511-514,517,共5页Journal of Huaihai Medicine

基　　金：蚌埠市科技局2014年科技立项(201400115)

摘　　要：目的:研究明胶海绵封堵对单侧穿刺经皮椎体后凸成形术(PKP)疗效的影响。方法:对60例骨质疏松性压缩性骨折(OVCF)患者行经皮椎体后凸成形术治疗,根据操作方法不同分为明胶海绵封堵组(联合组)和常规对照组(对照组)。观察2组手术时间、骨水泥注入量,手术前后疼痛视觉模拟评分(VAS)、椎体平均高度、骨水泥弥散系数,骨水泥渗漏等指标并加以分析。结果:全部病例随访6~12个月,对照组术前VAS评分为(6.58±1.57)分,末次随访VAS评分为(2.78±1.24)分;联合组术前VAS评分为(6.39±0.97)分,末次随访VAS评分(2.56±1.38)分;2组患者手术前后比较,差异有统计学意义(P<0.05)。对照组术前伤椎高度平均为(20.6±4.3)mm,术后为(29.7±3.2)mm;联合组术前伤椎高度平均为(21.3±3.5)mm,术后为(30.7±4.0)mm,2组患者手术前后比较差异有统计学意义(P<0.05);对照组术后X片测量骨水泥弥散系数为(57.3±8.7)%,联合组为(74.7±7.6)%,2组比较差异有统计学意义(P<0.05)。结论:明胶海绵封堵对单侧穿刺椎体后凸成形术后疗效无明显影响,但可以有效减少骨水泥渗漏的发生,改善骨水泥在椎体内的弥散。Objective： To investigate the therapeutic effect of gelatin sponge plugging in unilateral puncture percutaneous kyphoplasty （PKP）.Methods： 60 cases of patients with osteoporotic vertebral compression fracture （OVCF） underwent KPK and then were divided into a gelatin sponge plugging group （combination group） and a routine treatment group （control group）.The two groups were obseved and analyzed in terms of indexes such as operation time,bone cement infusion volume,VAS scores,mean vertebral height,diffusion coefficient of bone cement,and bone cement leakage.Results： All the cases were followed up 6 ~ 12 months.The preoperative VAS scores and the last follow-up VAS scores of the control group were （6.58 ± 1.57） and （2.78 ± 1.24） respectively,in contrast with the combination group＇s （6.39 ± 0.97） and （2.56 ± 1.38）.The pre-and post-operative differences of the two groups were of significance （P 0.05）.The pre-and post-operative mean wounded vertebral heights of the control group were （20.6 ± 4.3） and （29.7 ±3.2） respectively,while the combination group＇s were （21.3 ± 3.5） and （30.7 ± 4.0）.The pre-and post-operative differences of the two groups were statistically significant （P 0.05）.The post-operative bone cement diffusion coefficient was （57.3 ± 8.7） % for the control group and （74.7 ± 7.6） % for the combination group.There was statistic significance （P 0.05）.Conclusion： Gelatin sponge plugging used in unilateral puncture percutaneous kyphoplasty has no significant influence on the post-operative curative effect,but it can effectively reduce the bone cement leakage and improve the diffusion of bone cement in vertebrae.

关 键 词：骨质疏松 椎体压缩性骨折 经皮椎体后凸成形术 骨水泥 

分 类 号：R683.2[医药卫生—骨科学]