高粘度骨水泥联合PVP治疗骨质疏松性椎体压缩骨折的疗效及骨水泥渗漏的影响因素  

Therapeutic Effect of High Viscosity Bone Cement Combined with PVP against Osteoporotic Vertebral Compression Fractures and Factors Affecting Leakage of Bone Cement

作　　者：李文俊 张立国[1] 刘葛君 吴兴[1] LI Wenjun;ZHANG Liguo;LIU Gejun;WU Xing(Tenth People＇s Hospital of Tongii University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院,上海200072

出　　处：《解放军预防医学杂志》2018年第10期1286-1289,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：上海市科技局自然科学项目(自筹经费)(No.2017-SH-0254)

摘　　要：目的探讨高粘度骨水泥联合PVP治疗骨质疏松性椎体压缩骨折(OVCF)的疗效及骨水泥渗漏的相关影响因素。方法选择2016年1月-2017年5月收治的OVCF患者116例为研究对象,采用随机数字表法分为观察组和对照组,各58例,均行PVP手术治疗,观察组采用高粘度骨水泥,对照组采用普通骨水泥,术后随访1年以上,比较术前、术后3 d、术后1年两组患者VAS评分、ODI指数、伤椎前中后缘高度压缩率、Cobb角的矫正情况。统计观察组患者术后骨水泥渗漏发生率,采用Logistic回归分析术后骨水泥渗漏的相关因素。结果本研究两组患者术后均随访12～20个月,两组患者术后3 d、术后1年的VAS评分、ODI指数和伤椎Cobb角、前缘、中线及后缘平均高度压缩率均得到明显矫正,较术前有显著下降(P<0.05);且观察组明显优于对照组(P<0.05)。术后,观察组患者共13例(11.21%)发生骨水泥渗漏,经多因素Logistic回归分析显示,术前合并椎体周壁破坏、骨水泥注入量是导致高粘度骨水泥PVP术后发生骨水泥渗漏的危险因素(OR=1.897～2.433,P<0.05)。结论高粘度骨水泥联合PVP在恢复OVCF患者椎体生理结构及强度、缓解疼痛症状方面临床效果显著,骨水泥渗漏率较低;但骨水泥注入量较多以及术前合并椎体周壁破损的OVCF患者,术后仍难免会出现骨水泥渗漏,应引起临床重视。Objective To study the clinical effect of high viscosity bone cement combined with PVP on osteoporotic vertebral compression fractures and factors affecting the leakage of bone cement.Methods One hundred and sixteen cases of OVCF patients treated between January 2016 and May 2017 were selected as subjects. They were divided into the observation group and control group using the random number table,with 58 cases in each group. The follow-up was more than a year. The VAS score,ODI index,height of anterior posterior middle margin and the Cobb angle of the two groups were compared before operation and 3 D and 1 year after operation. The incidence of postoperative cement leakage in the observation group was statistically analyzed,and Logistic regression was used to analyze the related factors of postoperative cement leakage.Results The VAS score,ODI coefficient,Cobb angle,anterior edge,and median line average height compression rate were obviously corrected and significantly decreased after operation（ P〈0. 05）,especially in the observation group（ P〈0.05）. After operation,there were 13 cases（ 11.21%） of bone cement leakage in the observation group. The multiple factor Logistic regression analysis showed that the preoperative combined vertebral wall destruction and the injection of bone cement were the risk factors for bone cement leakage after high viscosity bone cement PVP（ OR = 1.897,2.433,P〈0.05）.Conclusion The clinical effect of high viscosity bone cement combined with PVP operation in restoring the body structure and strength of OVCF patients and alleviating pain symptoms is significant,and the leakage rate of bone cement is low. However,there are more bone cement injection and OVCF patients with a damaged circumferential wall of the vertebral body before operation. The leakage of bone cement will remain inevitable after operation,which deserves the attention of clinical doctors.

关 键 词：骨水泥渗漏 高粘度 骨质疏松 危险因素 骨折 

分 类 号：R683.2[医药卫生—骨科学]