不同手术方式治疗骨质疏松性胸腰椎压缩性骨折疗效分析  

Curative efficacy of different surgical methods for the treatment of osteoporotic vertebral compression fractures of the thoracolumbar spine

作　　者：张洪亮 翁阳华[2] 黎佩珍[2] 赵胜利 闵少雄[1] ZHANG Hong-liang;WENG Yang-hua;LI Pei-zhen;ZHAO Sheng-li;MIN Shao-xiong(Department of Spinal Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510282,Guangdong,CHINA;Department of Orthopaedics,Dongguan Humen Hospital,Dongguan 523902,Guangdong,CHINA;Department of Spinal Surgery,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,Guangdong,CHINA)

机构地区：[1]南方医科大学珠江医院脊柱外科,广东广州510282 [2]东莞市虎门医院骨科,广东东莞523902 [3]中山大学附属第一医院脊柱外科,广东广州510080

出　　处：《海南医学》2019年第20期2647-2650,共4页Hainan Medical Journal

基　　金：广东省东莞市社会科技发展(一般)项目(编号：2015105101145)

摘　　要：目的比较不同手术方式治疗骨质疏松性胸腰椎压缩性骨折患者的临床疗效。方法选择2016年1月至2018年1月南方医科大学珠江医院脊柱外科收治的100例骨质疏松性胸腰椎压缩性骨折患者作为研究对象,采用随机数表法将患者分为观察组和对照组各50例,对照组患者给予经皮椎体成形术(PVP)治疗,观察组患者采用经皮球囊扩张椎体后凸成形术(PKP)治疗。比较两组患者的治疗效果、手术时间、骨水泥灌注量、骨水泥渗漏情况、椎体高度恢复率和Cobb角的差异。结果治疗后,观察组患者的治疗优良率为94.0%,明显高于对照组的66.0%,差异有显著统计学意义(P<0.01);观察组患者手术时间、骨水泥灌注量分别为(34.21±7.18)min、(3.51±0.92)mL,明显低于对照组的(48.13±9.52)min、(5.82±1.23)mL,差异均有统计学意义(P<0.05);两组患者均发生骨水泥渗漏,观察组患者的椎旁软组织渗漏、椎旁静脉渗漏、椎间盘渗漏、椎间孔渗漏率分别为0、6.0%、0、0,显著低于对照组的26.0%、32.0%、22.0%、24.0%,差异均有显著统计学意义(P<0.05);治疗前,两组患者的椎体高度恢复率、Cobb角比较差异均无统计学意义(P>0.05);治疗后,观察组患者的椎体高度恢复率为(72.43±0.87)%,明显高于对照组的(33.61±1.13)%,Cobb角为(11.65±0.91)°,明显低于对照组的(16.34±0.73)°,差异均有统计学意义(P<0.05)。结论PKP治疗骨质疏松性胸腰椎压缩性骨折患者可有效减少手术时间,降低骨水泥渗漏,临床治疗效果显著。Objective To compare the curative efficacy of different surgical methods for the treatment of osteoporotic vertebral compression fractures of the thoracolumbar spine. Methods A total of 100 patients with osteoporotic vertebral compression fractures of the thoracolumbar spine were selected as subjects, who were admitted to the Department of Spinal Surgery at Zhujiang Hospital of Southern Medical University from January 2016 to January 2018. The patients were divided into observation group and control group with 50 cases in each group by the random number table method. Patients in the control group were treated with percutaneous vertebroplasty (PVP), and patients in the observation group were treated with percutaneous balloon kyphoplasty (PKP). The difference in treatment effect, operation time, bone cement perfusion, bone cement leakage, recovery rate of vertebral body height, and Cobb Angle were compared between the two groups. Results After treatment, the excellent and good rate of treatment in the observation group was 94.0%, which was significantly higher than 66.0% in the control group, and the difference was statistically significant (P<0.01). The operation time and bone cement perfusion volume were (34.21±7.18) min and (3.51±0.92) mL in the observation group, respectively, which were significantly lower than corresponding (48.13±9.52) min and (5.82±1.23) mL in the control group, with statistically significant differences (P<0.05). Bone cement leakage occurred in both groups. The rates of paravertebral soft tissue leakage (0 vs 26.0%), paravertebral vein leakage (6.0% vs 32.0%), intervertebral disc leakage (0 vs 22.0%) and intervertebral foramen leakage (0 vs 24.0%) were significantly lower in the observation group than in the control group, all differences were statistically significant (P<0.05). Before treatment, there was no significant difference in the recovery rate of vertebral height and Cobb Angle between the two groups (P>0.05). After treatment, the recovery rate of vertebral body height was (72

关 键 词：压缩性骨折 经皮椎体成形术 经皮球囊扩张椎体后凸成形术 骨质疏松 胸腰椎 疗效 

分 类 号：R683.2[医药卫生—骨科学]