PVP与PKP在治疗骨质疏松性椎体压缩骨折的临床效果及患者VAS ODI指数影响  

Clinical Effect of PVP and PKP in the Treatment of Osteoporotic Vertebral Compression Fractures and Its Influence on VAS and ODI Index of Patients

作　　者：黎泽森[1] 曾巧[1] LI Zesen;ZENG Qiao(The TCM Hospital of Panyu District in Guangzhou,Guangdong Panyu 511400,China)

机构地区：[1]广东省广州市番禺区中医院骨四区,广东广州511400

出　　处：《河北医学》2018年第7期1057-1060,共4页Hebei Medicine

摘　　要：目的:评价经皮椎体成形术(percutaneous vertebroplasty,PVP)与经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)在治疗骨质疏松性椎体压缩骨折的临床效果及对患者VAS、ODI指数的观察,探讨其临床适用性。方法:选择从2015年1月至2017年1月于我院就诊的86例骨质疏松性椎体压缩骨折患者,简单随机住院号的方法分为观察组43例和对照组43例,对照组患者给予PVP治疗,观察组患者给予PKP治疗。两组患者术后随访10个月。观察两组患者的手术一般情况,手术前后及随访复查时椎体恢复情况(Cobb角和椎体高度压缩率),同时采用视觉模拟疼痛评价(VAS评分)及腰椎功能障碍指数(ODI评分)评价两组患者的椎体功能改善情况及骨水泥渗漏情况。结果:两组患者手术过程均非常顺利,未出现神经根和脊髓损伤及死亡等不良事件,术中两组患者均成功穿刺,其中观察组单侧穿刺25个,双侧穿刺18个;对照组单侧穿刺26个,双侧穿刺17个。观察组患者的手术时间和骨水泥用量均高于对照组患者,差异有统计学意义(P<0.05)。两组患者术前的Cobb角、椎体高度压缩率、VAS评分及ODI指数比较,差异均无显著统计学意义(P>0.05),术后两组患者的Cobb角、椎体高度压缩率、VAS评分及ODI指数均显著降低,差异均有统计学意义(P<0.05),观察组患者和对照组患者术后的上述指标复查均无明显统计学差异(P>0.05),但在随访10个月后,观察组患者的Cobb角、椎体高度压缩率及VAS评分略低于对照组患者,差异有统计学意义(P<0.05),观察组患者术后骨水泥渗漏发生率为2.33%,对照组为13.95%,两组患者骨水泥渗漏发生率比较,差异有统计学意义(χ2=3.8912,P=0.0486)。结论:PVP与PKP治疗骨质疏松性椎体压缩骨折的临床效果显著,术后效果相当,但PKP术后随访的骨折愈合复位佳,骨水泥渗漏发生率低,远期预后效果优势明显。Objective:To analyze the clinical effect of PVP and PKP in the treatment of osteoporotic vertebral compression fractures and the influence on VAS and ODI,and to explore its clinical applicability.Methods:86 patients with osteoporotic vertebral compression fractures were selected from January 2015 to January 2017 in our hospital,and they were simple randomly divided into the observation group of 43 cases and the control group of 43 cases by the number of hospitalized.The control group was given PVP treatment,and the observation group was treated with PKP.The patients in the two groups were followed up for 10 months.And the operation situation of the two groups of patients,recovery of vertebral body(Cobb angle and vertebral compression rate)before and after surgery were observed;and VAS and ODI were used to evaluate the improvement of vertebral function and bone cement leakage in the two groups.Results:The patients with operation process of two groups were very smooth,no nerve root and spinal cord injury and death and other adverse events,during the operation of the patients of two groups were successfully punctured,the observation group of unilateral puncture 25,bilateral puncture 18;control group with unilateral puncture 26,bilateral puncture 17.The operation time and the amount of bone cement in the observation group were higher than those in the control group(P<0.05).The patients with anterior Cobb angle of two groups,vertebral compression rate,VAS and ODI were no different before the surgery(P>0.05).Cobb angle,vertebral compression rate,VAS score and ODI index of the patients of two groups after treatment were significantly decreased(P<0.05);and the examination indexes in the observation group and the control group of patients after surgery were no significant difference(P>0.05),but after 10 months of follow-up,the observation group of patients with Cobb angle and the vertebral compression rate and VAS score was slightly lower than that of the control group(P<0.05).The patients in the observation group after b

关 键 词：PKP PVP 骨质疏松症 压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]