经皮后凸成形术治疗骨质疏松性椎体压缩性骨折球囊压力的相关性探讨  

Correlation study of balloon pressure in the treatment of osteoporotic vertebral compression fractures by percutaneous kyphoplasty

作　　者：谢垒[1] 施涛[1] 邱勇钢[1] 陈美凯 许一凡 梁文清[2] XIE Lei;SHI Tao;QIU Yonggang;CHEN Meikai;XU Yifan;LIANG Wenqing(Department of Orthopedics,Shaoxing Second Hospital,Shaoxing 312000;Shaoxing People′s Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴第二医院骨科,浙江绍兴312000 [2]绍兴市人民医院,浙江绍兴312000

出　　处：《中国骨质疏松杂志》2020年第2期175-180,190,共7页Chinese Journal of Osteoporosis

基　　金：浙江省自然科学基金(LY18H060013);浙江省医药卫生临床研究计划项目(2017KY678);绍兴市科技计划项目(2018C30135)

摘　　要：目的探讨经皮后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩性骨折球囊压力的相关性。方法2008年1月至2017年6月骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)手术的患者209例,共269例椎体。其中女177例,男32例;平均年龄(75±8. 19)岁。根据磁共振成像(magnetic resonance imaging,MRI)信号改变分为不规则形组85例(A组,患者67例)、带状组56例(B组,患者42例)、裂隙征状组18例(C组,患者18例)和弥漫性组110例(D组,患者82例)。采用术中球囊压力及疼痛模拟视觉评分(visual analogue score,VAS)比较各组间差异。结果术中球囊破裂11例,其中A组5例,B组3例,C组1例,D组2例,各组之间比较差异无统计学意义(P>0. 05)。D组与A、B、C组之间球囊压力差异比较有统计学意义(P<0. 05),D组球囊压力最小;A、B、C组之间球囊压力两两比较差异无统计学意义(P>0. 05);各组患者术前、术后VAS比较差异有统计学意义(P<0. 001),各组间患者术前、术后VAS比较差异无统计学意义(P>0. 05)。结论 PKP治疗OVCF可获得满意疗效,弥漫性骨折术中球囊压力最小,术中需根据MRI骨折分型调控球囊压力,避免球囊破裂。Objective To explore the correlation of balloon pressure in the treatment of osteoporotic vertebral compression fractures by percutaneous kyphoplasty(PKP). Methods From January 2008 to June 2017,209 patients underwent surgery for osteoporotic vertebral compression fracture,including a total of 269 vertebral bodies. Among them,177 were female and 32 were male. The average age was 75±8. 19 years. According to MRI signal changes,there were 85 cases in the irregular shape group(group A,67 patients),56 cases in the ribbon group(group B,42 patients),18 cases in the cleft sign group(group C,18 patients) and 110 cases in the diffuse group(group D,82 patients). Intraoperative balloon pressure and visual analogue score(VAS) were used to compare the differences between the groups. Results There were 11 cases of intraoperative balloon rupture,including 5 cases in group A,3 cases in group B,1 case in group C,and 2 cases in group D. There was no statistically significant difference between the groups(P>0. 05).There were statistically significant differences in balloon pressure between group D and groups A,B and C(P<0. 05),and the balloon pressure in group D was the lowest. There was no significant pairwise difference in balloon pressure between groups A,B and C(P>0. 05). There were statistically significant differences in VAS pain index between pre-and post-operation in each group(P<0. 001),but there were no statistically significant differences between the groups pre-and post-operation(P>0. 05). Conclusion PKP in the treatment of OVCF could obtain satisfactory efficacy,and the balloon pressure is minimal during the operation for diffuse fractures.Intraoperative balloon pressure should be regulated according to MRI fracture classification to avoid balloon rupture.

关 键 词：骨质疏松 椎体压缩性骨折 经皮后凸成形术 球囊压力 

分 类 号：R683.2[医药卫生—骨科学]