体外冲击波联合过伸体位复位后PVP对绝经后女性骨质疏松性胸腰段压缩骨折疗效分析  

Effect analysis of extracorporeal shock wave combined with PVP after reduction in hyperextension position on osteoporotic compression fracture of thoracolumbar segment in postmenopausal women

作　　者：王慧[1] 孙晓东[2] 王明玲[3] 牟爱华 邱玉金[4] 刘晓伟[4] 张学玲[5] 王胜[4] WANG Hui;SUN Xiaodong;WANG Mingling;MOU Aihua;QIU Yujin;LIU Xiaowei;ZHANG Xueling;WANG Sheng(Operating Room,the Affiliated Hospital of Weifang Medical Univeisity,Weifang 261041,China;Department of Endocrinology tthe Affiliated Hospital of Weifang Medical Univeisity;Department of Anesthesiology,Weifang Medical Univeisity;Department of Spine Surgery,the Affiliated Hospital of Weifang Medical Univeisity;Department of Rehabilitation,the Affiliated Hospital of Weifang Medical Univeisity)

机构地区：[1]潍坊医学院附属医院手术室,山东潍坊261041 [2]潍坊医学院附属医院内分泌科 [3]潍坊医学院麻醉学系 [4]潍坊医学院附属医院脊柱外科 [5]潍坊医学院附属医院康复科

出　　处：《潍坊医学院学报》2020年第2期146-149,共4页Acta Academiae Medicinae Weifang

基　　金：山东省医药卫生科技发展计划项目资助课题(课题编号:2017WS170)。

摘　　要：目的探讨体外冲击波(ESW)联合过伸体位复位后经皮穿刺椎体成形术(PVP)对绝经后女性骨质疏松性胸腰段压缩骨折的临床疗效。方法将81例绝经后女性骨质疏松性胸腰段压缩骨折患者随机分为单纯行PVP治疗组(33例)、过伸体位复位后PVP治疗组(P-PVP组,29例)、ESW联合过伸体位复位后PVP组(EP-PVP组,19例),对比3组患者的临床疗效。结果行过伸体位复位的两组手术时间均长于单纯PVP组,差异有统计学意义(P<0.05);术后3组椎体骨折压缩率较术前均降低(P<0.05);过伸体位复位的两组椎体复位率高于单纯PVP组(P<0.05);术后P-PVP组和单纯PVP组的VAS评分(包括术后第1天和术后2~3个月)和ODI评分差异均无统计学意义(P>0.05);术后2~3个月的VAS评分和ODI评分,体外EP-PVP组与单纯PVP组、P-PVP组比较差异有统计学意义(P<0.05)。结论3种治疗方案均能较好地治疗胸腰椎骨质疏松性压缩骨折,缓解疼痛,改善生活质量。单纯PVP组、P-PVP组行过伸体位复位后PVP能更好地恢复椎体前缘高度,纠正后凸畸形,提高骨折椎体稳定性。Objective To investigate the clinical effect of extracorporeal shock wave(ESW)combined with hyperextension reduction and percutaneous vertebroplasty(PVP)on osteoporotic thoracolumbar compression fractures in postmenopausal women.Methods Eighty-one postmenopausal women with osteoporotic thoracolumbar compression fracture were randomly divided into three groups:PVP group(33 cases),P-PVP group(29 cases)and EP-PVP group(19 cases).The clinical effects of three groups were compared.Results The operation time of the two groups undergoing hyper-extension was longer than PVP group(P<0.05);The compression rate of vertebral fracture in the three groups after operation was lower than that before operation(P<0.05);The reduction rate of vertebral body in the two groups was higher than the PVP group(P<0.05).There was no statistically significant difference in VAS score and ODI score between the P-PVP group and the PVP group after surgery(including the 1 st day after surgery and the 2 nd to 3 rd month after surgery).And for VAS score and ODI score 2~3 months after the operation,the EP-PVP group was significantly different from the PVP group and the P-PVP group(P<0.05).Conclusion All these three treatments can effectively treat thoracolumbar osteoporotic compression fracture,relieve the pain and improve life quality.However,compared witn the EP-PVP group,PVP can better restore the height of the anterior edge of the vertebral body,correct kyphotic deformity,and improve the stability of the fractured vertebral body after the reduction in the other two groups.

关 键 词：体外冲击波 经皮穿刺椎体成形术 骨质疏松性胸腰段压缩骨折 

分 类 号：R683.2[医药卫生—骨科学]