重度骨质疏松患者腰椎骨折术后抗骨质疏松治疗的效果  

Effect of anti-osteoporosis treatment on patients with severe osteoporosis after receiving operation for lumbar fractures

作　　者：朱曙光[1] 肖捷[1] 白欣[1] 王殷红 

机构地区：[1]浙江省建德市第一人民医院骨科,浙江建德311600

出　　处：《实用药物与临床》2017年第12期1403-1406,共4页Practical Pharmacy and Clinical Remedies

基　　金：2014年浙江省卫生部医药卫生科技发展研究中心课题(W2014ZT320)

摘　　要：目的研究重度骨质疏松患者腰椎骨折术后抗骨质疏松治疗的临床疗效。方法选取我院2014年6月至2016年1月收治的重度骨质疏松腰椎骨折患者86例,采用随机数字法将其分为对照组和观察组,每组43例。两组患者均给予经皮椎体后凸成形术治疗,观察组术后静脉滴注唑来膦酸治疗,术后均接受随访。比较两组患者术前、术后4周及末次随访的疼痛程度、活动能力、椎体前缘和中部高度、Cobb角和骨密度(BMD)。结果末次随访显示,观察组的VAS、ODI评分和Cobb角均明显低于对照组(P<0.05),椎体前缘高度和椎体中部高度高于对照组(P<0.01),BMD高于对照组(t=8.17,P=0.00);观察组的再次骨折发生率明显低于对照组(χ2=5.93,P=0.01)。结论重度骨质疏松腰椎骨折经皮椎体后凸成形术后服用唑来膦酸治疗可有效缓解疼痛,提高日常活动能力和椎体稳定性,还可增加患者的BMD,降低远期骨折再发生率,是一种安全可靠的治疗方案,值得临床推广。Objective To study the clinical efficacy of anti-osteoporosis treatment for patients with severe osteoporosis after receiving operation for lumbar fractures. Methods Totally 86 patients with severe osteoporosis lumbar fractures in our hospital from June 2014 to January 2016 were divided into control group and observation group using random number method,43 cases in each group. All the patients were treated with percutaneous kyphoplasty,and patients in observation group were treated with intravenous drip of zoledronic acid in addition. Both groups were followed up after operation. The degree of pain,activity,vertebral height,Cobb and bone density（ BMD） between the two groups were compared. Results Final follow-up showed that,compared with control group,the VAS and ODI scores and Cobb angle in observation group were lower（ P 〈 0. 05）,while vertebral height and BMD were higher（ P 〈0. 01）. The incidence of re-fracture in observation group was significantly lower than that of control group（ χ2= 5. 93,P = 0. 01）. Conclusion Zoledronic acid treatment for severe lumbar fractures after percutaneous kyphoplasty can effectively alleviate pain,improve the ability of daily activity and stability of centrum,and increase the BMD of patients,thus reducing the incidence of future fracture,which deserves clinical promotion because of the safety and reliability.

关 键 词：重度骨质疏松 腰椎骨折 经皮椎体后凸成形术 唑来膦酸 

分 类 号：R580[医药卫生—内分泌] R687.3[医药卫生—内科学]