PKP和PVP治疗骨质疏松性椎体压缩骨折的疗效比较  

Clinical effect comparison of PKP and PVP in the treatment of osteoportic vertebral compression fractures

作　　者：李小宏[1] 张有为[1] 刘列[1] 肖文兴[1] 宋宁亚[1] LI Xiao-hong;ZHANG You-wei;LIU Lie;XIAO Wen-xing;SONG Ning-ya(SectionⅠ,Dept of Orthopaedics Central Hospital of Baoji City,Baoji,Shaanxi721008,China)

机构地区：[1]宝鸡市中心医院骨一科,陕西宝鸡721008

出　　处：《临床骨科杂志》2018年第2期150-152,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折的疗效。方法将98例骨质疏松性椎体压缩骨折患者分成PKP组和PVP组,两组各49例。观察两组手术时间、骨水泥注入量、术后住院时间、手术费用、术后VAS评分及血清胰岛素样生长因子(IGF)水平变化,评价生活活动能力评分Barthel指数(BI)及临床治疗效果。结果患者均获得随访,时间9.8~12.7个月。PKP组手术时间、骨水泥注入量、术后住院时间、手术费用均显著长(多)于PVP组,差异均有统计学意义(P<0.05)。术后第1天,VAS评分两组均较术前显著降低,差异有统计学意义(P<0.05);两组间比较差异无统计学意义(P>0.05)。术后第1天,两组血清IGF水平及骨生化指标均较术前显著改善(P<0.05);PKP组血清IGF水平及骨钙素水平显著高于PVP组(P<0.05)。术后BI两组比较差异无统计学意义(P>0.05)。术后PKP组骨水泥渗漏、感染、再骨折、一过性发热发生率均显著低于PVP组(P<0.05)。结论 PKP和PVP都可以显著缓解骨质疏松性椎体压缩骨折患者的疼痛,且能获得满意疗效。PKP术后更可以促进血清IGF水平升高,改善骨质疏松。Objective To compare the efficacy of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures.Methods The 98 patients with osteoporotic vertebral compression fractures were randomly divided into the PKP group and the PVP group by double blind method,49 cases in each group.The operation time,PMMA injection volume,posteroprative hosptitaliztion time,surgery cost,postoperative VAS,the serum insulin-like growth factor(IGF)levels were observed,and the life activity ability score Barthel index(BI),the clinical treatment effect were evaluated.Results All patients were followed up for 9.8~12.7 months.The operation time,the PMMA injection volume,postoperative hospitalization time and the cost were all significantly higher(more)in PKP group than those in PVP group,the differences were statistically significant(P<0.05).The VAS of two groups on the first day postoperatively were significantly lower than those of the preoperative,the differences were statistically significant(P<0.05),there was no significant difference between the two groups(P>0.05).Compared with the preoperative,serum IGF levels and bone biochemical indexes of the two groups on the first day postoperatively were improved significantly(P<0.05).The serum IGF level and osteocalcin level in PKP group were significantly higher than those in PVP group(P<0.05);there was no significant difference between the BI of the PKP group and the PVP group(P>0.05).The complication incidence rate of bone cement leakage,infection,refracture,a transient fever in PKP group were significantly lower than those in the PVP group(P<0.05).Conclusions PKP and PVP both can significantly relieve the pain of osteoporotic vertebral compression fractures paitents,and the treatment effects is satisfactory.After PKP operation,the level of serum IGF can be promoted and osteoporosis can be improved.

关 键 词：经皮椎体后凸成形术 经皮椎体成形术 椎体压缩性骨折 VAS评分 血清胰岛素样生长因子 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]