不同骨水泥灌注量经单侧PVP治疗骨质疏松性椎体压缩骨折的临床疗效  

The effect of different bone cement perfusion in unilateral PVP on clinical curative effect in the treatment of osteoporotic vertebral compression fractures

作　　者：吴若丹[1] WU Ruo-dan(The First Department of Orthopedics, Jiaozuo People's Hospital, Jiaozuo 454000, Henan, China)

机构地区：[1]河南省焦作市人民医院骨一科,河南焦作454000

出　　处：《实用医院临床杂志》2019年第1期131-133,共3页Practical Journal of Clinical Medicine

基　　金：河南省自然科学基金资助项目(编号:201681468)

摘　　要：目的观察不同骨水泥灌注量经单侧经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)的临床疗效及并发症影响。方法选取86例行单侧PVP治疗OVCF患者,按随机数字表法分为两组各43例,A组使用小剂量骨水泥灌注,B组使用常规剂量骨水泥灌注,比较两组治疗前与结束随访时椎体高度变化、责任椎Cobb角、视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数(ODI),并观察两组手术指标、骨水泥渗漏事件与并发症情况。结果两组手术时间及术中出血量比较差异无统计学意义(P> 0. 05),A组骨水泥灌注量少于B组(P <0. 05);两组治疗前与结束随访时椎体前壁高度、椎体中间高度、责任椎Cobb角、VAS评分、ODI比较差异无统计学意义(P> 0. 05),两组结束随访时椎体前壁高度、椎体中间高度均较治疗前明显增加,责任椎Cobb角、VAS评分及ODI均较治疗前明显减小(P <0. 05); A组骨水泥渗漏事件发生率、并发症总发生率低于B组(P <0. 05)。结论在PVP治疗OVCF中使用小剂量或者常规剂量骨水泥灌注均能获得良好疗效,其中小剂量骨水泥灌注具有减少骨水泥渗漏事件、降低术后并发症发生率优势,安全性更高。Objective To observe the effect of different bone cement perfusion in unilateral percutaneous vertebroplasty( PVP) on clinical curative effect and complications in the treatment of osteoporotic vertebral compression fractures( OVCF).Methods Eighty-six patients undergoing the unilateral PVP for OVCF were randomly divided into A and B groups,43 in each group.The group A was treated with low-dose bone cement perfusion,and the group B was treated with conventional dose perfusion.Changes of vertebral height,responsible vertebral Cobb angle,pain visual analogue scale( VAS) scores and Oswestry disability index( ODI) were compared between the two groups before treatment and at the end of follow-up.The surgical indexes,bone cement leakage and complications in the two groups were observed.Results There was no significant difference in the surgical time or intraoperative blood loss between the two groups( P > 0. 05).The bone cement perfusion in the group A was significantly less than that in the group B( P < 0. 05).There was no significant difference in the vertebral anterior wall height,middle vertebral height,responsible vertebral Cobb angle,VAS score or ODI between the two groups before treatment and during the period of follow-up( P > 0. 05).However,at the end of follow-up,the vertebral anterior wall height and middle vertebral height in both groups were significantly increased while responsible vertebral Cobb angle,VAS score and ODI were significantly decreased when compared with those before treatment( P < 0. 05).The incidence rate of bone cement leakage and total incidence of complications in the group A were significantly lower than those in the group B( P < 0. 05).Conclusion Both low-dose and conventional-dose bone cement in PVP for OVCF can achieve good curative effect. Low-dose bone cement perfusion has advantages of reducing bone cement leakage and the incidence of postoperative complications.Its safety is higher.

关 键 词：骨水泥灌注量 单侧 经皮椎体成形术 骨质疏松 椎体压缩骨折 

分 类 号：R683.2[医药卫生—骨科学]