唑来膦酸对老年椎体压缩性骨折PVP术后短期疗效的影响  

Effect of zoledronic acid on short-term efficacy of PVP for vertebral compression fracture in elderly

作　　者：刘晓宁[1] 鞠阳[2] 孔莉[3] 孔德明[1] 仝超[1] 肖继龙 赵洪波 李红梅[2] 李贵宾 王浩军[1] LIU Xiaoning;JU Yang;KONG Li;KONG Deming;TONG Chao;XIAO Jilong;ZHAO Hongbo;LI Hongmei;LI Guibin;WANG Haojun(Department of Orthopedics, Handan District of Jizhong Energy Fengfeng Group General Hospital, Han Dan, Hebei 056001, China)

机构地区：[1]冀中能源峰峰集团总医院邯郸院区骨科,河北056001 [2]冀中能源峰峰集团总医院邯郸院区心内科,河北056001 [3]邯郸市第四医院内科,河北056001 [4]冀中能源峰峰集团总医院邯郸院区外科,河北056001

出　　处：《中国骨科临床与基础研究杂志》2019年第1期25-29,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：邯郸市科技局科技项目(1823208014ZC)

摘　　要：目的探讨唑来膦酸对经皮椎体成形术(PVP)治疗老年椎体压缩性骨折(VCF)短期疗效的影响。方法选取2015年1月至2018年6月收治的230例行PVP手术的老年VCF患者,依据术后是否应用唑来膦酸分为治疗组(162例)和对照组(68例),治疗组术后给予唑来膦酸治疗,对照组仅行PVP。比较两组患者手术前后Cobb角、椎体前缘高度、骨密度、视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI)的差异。结果PVP术后两组各疗效指标均较术前明显改善(P <0.05)。两组比较,术后3、6个月Cobb角、椎体前缘高度、VAS评分、ODI及术后3个月骨密度均无明显差异(P>0.05);术后6个月治疗组骨密度明显高于对照组(P <0.05)。结论对于老年VCF患者,PVP手术可有效矫正椎体后凸,恢复椎体前缘高度,缓解疼痛及改善椎体功能,短期疗效显著;术后应用唑来膦酸对这些手术效果无显著影响,但能更好地改善患者骨密度,至于中长期效果,还有待进一步观察。Objective To explore the effect of zoledronic acid on short-term efficacy of percutaneous vertebroplasty (PVP) in elderly patients with vertebral compression fracture (VCF). Methods A total of 230 elderly VCF patients who underwent PVP from January 2015 to June 2018 were selected. According to the postoperative application of zoledronate, the patients were divided into treatment group (n = 162, given zoledronic acid after PVP) and control group (n = 68, only received PVP). Preoperative and postoperative Cobb angle, anterior vertebral body height, bone mineral density (BMD), visual analogue scale (VAS) score, and Oswestry disability index (ODI) were compared between two groups. Results All parameters were significantly improved after PVP in both groups (P <0.05). There were no statistical differences in Cobb angle, anterior vertebral body height, VAS score and ODI between two groups at 3, 6 months postoperatively, so was BMD at 3 months after the surgery (P >0.05). While in treatment group, BMD at 6 months postoperatively was higher than that in control group (P <0.05). Conclusions For elderly VCF patients, PVP could correct verteral kyphosis, restore the anterior verteral body height, relieve pain and improve verteral function with good short-term efficacy. Application of zoledronic acid after PVP has no significant influence on those surgical effects, but it could increase BMD significantly. But for mid-term and long-term effects, it needs further observation.

关 键 词：脊柱骨折 椎体成形术 唑来膦酸 骨密度 老年人 

分 类 号：R683.2[医药卫生—骨科学] R687.42[医药卫生—外科学]