低温骨水泥灌注技术在经皮椎体成形术中的应用  

Low temperature cement injection technique in percutaneous vertebroplasty for osteoporotic vertebral body compression fractures

作　　者：张洋[1] 龙浩[1] 邹伟[1] 肖杰[1] 周昌俊[1] 刘杰[1] 王国贤 ZHANG Yang,LONG Hao,ZOU Wei,XIAO Jie,ZHOU Chang-jun,LIU Jie,WANG Guo-xian(Guiyang No.4 People s Hospital,Guiyang 550002,Chin)

机构地区：[1]贵阳市第四人民医院脊柱外科,贵阳550002

出　　处：《创伤外科杂志》2018年第8期575-578,共4页Journal of Traumatic Surgery

摘　　要：目的比较低温灌注技术与常温灌注技术,评价其在经皮椎体成形术(percutaneous vertebroplasty,PVP)中治疗骨质疏松性椎体压缩性骨折中的疗效。方法回顾性分析贵阳市第四人民医院脊柱外科2015年1月—2017年1月诊断为胸腰椎骨质疏松性压缩性骨折并行PVP治疗的66例患者,按骨水泥灌注技术不同分为常温灌注组(采用常温下调制好骨水泥分两次灌注的方法)33例、36个椎体,低温灌注组(将调好的骨水泥置于0℃冰盐水中缓慢、低压、间断灌注)33例、35个椎体。比较术前、术后3d及末次随访(术后6~15个月)时两组的视觉模拟评分(VAS),Oswestry功能指数(ODI),伤椎椎体前缘高度,椎体后凸角度,骨水泥渗漏及弥散情况。结果低温灌注组的骨水泥工作时间(10.2±1.2)min明显长于常温组(8.3±1.5)min,差异有统计学意义(P<0.05),两组术后平均随访(12.7±4.5)个月和(12.4±2.9)个月,差异无统计学意义(P>0.05)。两组患者VAS评分、ODI术后与术前比较差异有统计学意义(P<0.05);末次随访与术后比较常温灌注组差异有统计学意义(P<0.05),低温灌注组差异无统计学意义(P>0.05);两组患者组间比较VAS评分、ODI末次随访时差异有统计学意义(P<0.05),其余时间点差异无统计学意义(P>0.05)。两组之间伤椎椎体前缘高度和椎体后凸角度比较术前、术后及末次随访时上述指标差异无统计学意义(P>0.05)。低温灌注组骨水泥同时接触上下终板比例多于常温组(P<0.05),低温灌注组骨水泥渗漏率显著低于常温灌注组(P<0.05)。结论骨水泥低温灌注技术应用于椎体成形术时,可以显著延长骨水泥的工作时间,在获得良好骨水泥弥散效果的同时,有效降低渗漏率,可以获得满意的临床效果。Objective To explore the clinical efficacy of low temperature cement injection technique in percutaneous vertebroplasty （PVP） for osteoporotic vertebral compression fractures（OVCF） by comparing with normal temperature cement injection technique. Methods A total of 66 patients with OVCF from Jan. 2015 to Jan. 2017 were reviewed.The patients were divided into normal temperature cement injection group （mixing the cement in normal temperature and injection for two times） and low temperature cement injection group （mixing the cement and placing it in 0℃ normal saline and in slow,low pressure,staged cement injection）. The normal temperature cement injection group included 33 patients with 36 fractured vertebras. Low temperature injection group included 33 patients with 35 fractured vertebras. Outcomes were evaluated pre- and postoperatively by using visual analogue score（VAS）,Oswestry disability index（ODI）,and the anterior vertebral height,the local kyphosis angle,the cement dispersion and leakage were compared. Results The difference of cement working time（10.2±1.2）min in the low temperature injection group was significantly higher than that in the normal temperature group（ P 〈0.05）.The average follow-up of the two groups was （12.7±4.5）months and （12.4±2.9）months,and there was no significant difference between the two groups（ P 〉0.05）. The VAS score and ODI were significantly improved after operation in both groups（ P 〈0.05）,there was statistical difference between the final follow-up and postoperation in normal temperature cement injection group while no statistical significance in the low temperature cement injection group（ P 〉 0.05）.As for VAS score and ODI,there was statistical difference at the final follow-up（ P 〈 0.05） while no statistical significance at the rest of the time（ P 〉0.05）between the two groups. As for the anterior injured vertebral height and the kyphosis angle,there was no statistical difference at preoperation,postop

关 键 词：胸腰椎骨折 椎体成形术 骨水泥 灌注 低温 

分 类 号：R683.2[医药卫生—骨科学]