老年人椎体成形术实施日间手术的疗效和安全性评估  

Evaluation of the efficacy and safety of vertebroplasty as a day surgery procedure

作　　者：张啟维[1] 孙常太[1] 王强[1] Zhang Qiwei;Sun Changtai;Wang Qiang(Department of Orthopedics,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院骨科,国家老年医学中心,中国医学科学院老年医学研究院

出　　处：《中华老年医学杂志》2020年第11期1318-1322,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨老年人椎体成形术日间手术治疗骨质疏松椎体骨折(OVF)的有效性和安全性。方法回顾性队列研究,分析159例北京医院骨科施行椎体成形术治疗OVF患者,日间手术组81例,1个工作日内安排患者住院、手术、手术后短暂观察及恢复和办理出院;住院手术组78例,患者在医院过夜或住院时间超过24h。平均随访时间12.3月(12-14个月)。分析两组患者手术前、术后1周及末次随访疼痛评分、镇痛药物使用、活动能力情况;统计两组患者临床效果、术中及术后并发症。结果日间手术组患者行椎体成形术后组内比较,手术后1周和末次随访疼痛评分、镇痛药物使用、活动能力评分与术前比较差异有统计学意义(均P<0.01).日间手术组和住院手术组患者比较,术后1周、末次随访的疼痛评分[(2.3±1.2)分比(2.4±1.2)分、(1.7±0.9)分比(1.6±0.8)分]、镇痛药物使用[(1.5±0.3)分比(1.3±0.7)分、(1.8±0,4)分比(1.6±0.6)分]及活动能力评分[(1.3±0.7)分比(1.3±0.9)分、(1.3±0.6)分比(1.4±0.5)分],差异无统计学意义(均P>0.05)。日间手术组与住院手术组患者术中出血量、术后并发症(脑脊液漏、骨水泥外溢、穿刺部位血肿或感染、神经根刺激症状、再骨折)比较,差异无统计学意义(均P>0.05)。结论日间手术模式下应用椎体成形术治疗OVF术后疼痛评分、疼痛药物使用、活动能力均较术前改善。与住院手术模式疗效和安全性相当。Objective To investigate the surgical efficacy and safety of vertebroplasty as a day surgery procedure for osteoporotic vertebral fracture(OVF).Methods A total of 159 patients with OVF undergoing vertebroplasty in Department of Orthopaedics,Beijing Hospital were enrolled and the clinical data were analyzed in this retrospective cohort study.They were grouped as the day-surgery group(n=81,the hospitalization,operation,briefly observation,recovered and discharged after treatment were completed during 1 working day)and as the hospitalized surgery group(n=78,patients stayed overnight in hospital or were hospitalized more than 24 hours).The mean follow-up time was 12.3 months(12-14 months).Pain score,analgesic drug use and activity ability were compared between the two groups before operation,1 week after operation and at the last follow-up.Clinical effect,intra-operative and post-operative complications in the two groups were observed.Results In intra-group comparison in the day-surgery group,the pain score,analgesic drug use and activity ability showed statistically significant differences at 1 week after surgery and at last follow-up as compared with those before treatment(P<0.01).No significant differences in pain score,analgesic drug use and activity ability were found between the day-surgery group and the hospitalized surgery group at 1 week after operation and at the last follow-up(2.3±1.2-us.2.4±1.2,1.7±0.9 vs.1.6±0.8;1.5±0.3 us.1.3±0.7,1.8±0.4vs.1.6±0.6;1.3±0.7 vs.1.3±0.9,1.3±0.6 vs.1.4±0.5;all P>0.05).The blood loss during surgery,postoperative complications including cerebrospinal fluid leakage,bone cement leakage,hematoma or infection at the puncture site,nerve root stimulation symptoms and re-fracture had no statistical difference between the two group(all P>0.05).Conclusions The vertebroplasty as a day-surgery mode for osteoporotic vertebral fracture can improve the postoperative VAS score and activity ability,and decrease pain medication use.Efficacy and safety of a day-surgery for OVF are c

关 键 词：骨质疏松 椎体骨折 日间住院医疗 

分 类 号：R687.3[医药卫生—骨科学]