术前体位干预联合高黏度骨水泥注入治疗骨质疏松椎体压缩性骨折的临床疗效  

Clinical effect of preoperative postural intervention combined with high viscosity bone cement injection in the treatment of osteoporotic vertebral compression fractures

作　　者：江亚[1] 刘群[1] 刘锴[1] 

机构地区：[1]合肥市第三人民医院骨二科,安徽230022

出　　处：《创伤外科杂志》2017年第12期932-935,共4页Journal of Traumatic Surgery

摘　　要：目的探讨术前体位干预联合高黏度骨水泥注入治疗骨质疏松椎体压缩性骨折的临床疗效及安全性。方法分析2012年1月—2016年1月合肥市第三人民医院骨科收治的50例骨质疏松椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)患者的临床资料,按处理方式分为对照组(25例)和观察组(25例)。对照组采用常规经皮椎体成形术(pepcutaneous vertebroplasty,PVP)术治疗,观察组在对照组基础上加用术前体位干预联合高黏度骨水泥注入治疗;比较两组患者手术用时、术中出血量、骨水泥用量、手术前后视觉模拟评分(VAS)、Oswestry功能障碍指数问卷表评分(ODI)、伤椎高度压缩率、Cobb角及术后并发症发生率等。结果两组手术用时、术中出血量、骨水泥用量比较差异无统计学意义(P>0.05);术后两组患者VAS评分和ODI评分均较术前显著降低(P<0.05);观察组VAS评分和ODI评分均显著低于对照组(P<0.05)。术前两组患者伤椎前缘、后缘、中线高度压缩率及Cobb角比较差异无统计学意义(P>0.05);术后12个月两组伤椎前缘高度压缩率、中线高度压缩率及Cobb角均较术前显著降低,观察组伤椎前缘高度压缩率、中线高度压缩率及Cobb角显著低于对照组(P<0.05);两组治疗前后伤椎后缘高度压缩率比较差异无统计学意义(P>0.05);两组术后背部不适发生率比较差异无统计学意义(P>0.05)。结论术前体位干预联合高黏度骨水泥注入用于行PVP术治疗的OVCF患者可有效减轻疼痛程度,促进肢体功能恢复,改善伤椎前缘高度压缩率、中线高度压缩率及Cobb角,并有助于降低骨水泥渗漏率。Objective To investigate the clinical efficacy and safety of preoperative postural intervention combined with high viscosity bone cement injection in the treatment of osteoporotic vertebral compression fractures.Methods The clinical data of 50 patients with osteoporotic vertebral compression fractures（OVCF） admitted to the Department of Orthopedics of the Third People＇s Hospital of Hefei from Jan.2012 to Jan.2016 was retrospectively analyzed.The patients were randomly divided into control group（25 cases） and observation group（25 cases） according to the random number table method.The control group was treated with conventional percutaneous vertebroplasty（PVP）,and the observation group was given preoperative postural intervention combined with high viscosity bone cement injection treatment on the basis of the control group.The operation time,intraoperative blood loss,and bone cement,the visual analogue scale（VAS） before and after the operation,Oswestry disability index（ODI）,the height of vertebral compression rate,Cobb angle and the incidence of postoperative complications were compared between the two groups.Results There was no significant difference in the operation time,intraoperative blood loss,bone cement between the two groups（P〈0.05）.After surgery,the VAS score and ODI score of the two groups were significantly lower than those before surgery（P〈0.05）,and the VAS score and ODI score of the observation group were significantly lower than those of the control group（P〈0.05）.There was no statistical difference in preoperative vertebral and posterior midline height,compression ratio and Cobb angle between the two groups（P〈0.05）.Twelve months after surgery,the anterior vertebral height compression rate,compression rate and Cobb angle of midline height obviously reduced compared with preoperatively,and the anterior vertebral height,midline compression rate high compression rate and Cobb angle of the observation group was significantly lower than those of the control

关 键 词：椎体骨折 骨质疏松 体位干预 骨水泥 

分 类 号：R683.2[医药卫生—骨科学]