PVP对骨质疏松椎体压缩性骨折患者疼痛程度、腰椎功能及负性情绪的影响  

Effects of percutaneous vertebroplasty on pain degree, lumbar function and negative mood in patients with osteoporotic vertebral compression fractures

作　　者：胡德洪[1] 王京华[1] 彭仲华[1] 韦昌南[1] HU Dehong;WANG Jinghua;PENG Zhonghua;WEI Changnan(Department of Orhtopaedics Ⅰ, Sanshui Hospital, Foshan TCM Hospital, Foshan, Guangdong 528000, China)

机构地区：[1]佛山市中医院三水医院骨一科,广东528000

出　　处：《中国骨科临床与基础研究杂志》2017年第2期92-97,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探讨经皮椎体成形术(PVP)对骨质疏松椎体压缩性骨折(OVCF)患者疼痛程度、腰椎功能及负性情绪的影响。方法将2015年6月至2016年7月佛山市中医院三水医院收治的60例OVCF患者,按治疗方式分为保守组(37例)和研究组(23例),保守组采用常规保守治疗,研究组行PVP治疗。计算两组治疗总有效率,观察两组患者治疗前后疼痛程度、腰椎功能、伤椎椎体高度及负性情绪的变化,比较两组治疗后SF-36生活质量评分的差异。结果研究组治疗总有效率高于对照组(96%vs 70%),两组比较,差异有统计学意义(P<0.05);治疗3 d、7 d、1个月、3个月,两组视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)较治疗前均有明显改善,治疗后同一时相点研究组均优于保守组(P<0.05);治疗3个月后研究组伤椎椎体前缘、中央及后缘高度,SF-36生存质量量表各项目评分及总分,焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均较保守组明显改善(P<0.05)。结论与保守疗法相比,PVP短期内能有效缓解OVCF患者疼痛症状,改善腰椎功能,恢复并维持椎体高度,减轻抑郁焦虑状态,提高患者生活质量。Objective To explore the effects of percutaneous vertebroplasty(PVP)on pain degree,lumbarfunction and negative mood in patients with osteoporotic vertebral compression fractures(OVCF).Methods Sixtypatients with OVCF treated in Sanshui Hospital of Foshan TCM Hospital from June2015to July2016,weredivided into conservation group(receiving conventional treatment,n=37)and study group(receiving PVP,n=23)according to the different treatment method.Total effective rate was calculated in two groups,changes ofpain degree,lumbar function,vertebral body heights,and negative mood in two groups were observed before and after the treatment,SF-36scores after treatment were also compared between two groups.Results Total effectiverate in study group was higher than that of control group(96%vs70%),the difference between two groups wasstatistically significant(P<0.05);At3d,7d,1month and3months after the treatment,visual pain scale(VAS)score and Oswestry disability index(ODI)in study group were all lower than those in control group,also,theindicators after the treatment were all improved compared with the pre-treatment ones(P<0.05);At3monthsafter the treatment,the vertebral body heights of anterior edge,central and posterior edge,SF-36scores in allitems as well as its total scores,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores instudy group showed significantly superior results compared with control group(P<0.05).Conclusion Comparedto conservative therapy,in the short term,PVP could effectively relieve the pain,improve lumbar function,restore and maintain the vertebral height,alleviate the anxiety and depression status,and improve the quality oflife for OCVF patients.

关 键 词：骨质疏松 脊柱骨折 经皮椎体成形术 疼痛 手术后 关节功能 生活质量 焦虑 抑郁 应激 心理学 

分 类 号：R687.3[医药卫生—骨科学]