两种骨水泥推注技术治疗椎体压缩性骨折的临床疗效  

The Clinical Effect of Two Bone Cement Injection Techniques in the Treatment of Vertebral Compression Fractures

作　　者：蔡鑫 俞鹏飞[1] 韩松 李红卫[1] 王根林[2] CAI Xin;YU Peng-fei;HAN Song;LI Hong-wei;WANG Gen-lin(Department of Spine Surgery,Suzhou Traditional Chinese Medicine HospitalAffiliated to Nanjing University of Chinese Medicine,Nanjing 215009,Jiangsu,China;Department of Spine Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)

机构地区：[1]南京中医药大学附属苏州市中医医院脊柱外科,江苏南京215009 [2]苏州大学附属第一医院脊柱外科,江苏苏州215006

出　　处：《医学信息》2020年第23期80-83,共4页Journal of Medical Information

摘　　要：目的探讨两种骨水泥推注技术治疗骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法收集2014年1月~2017年1月我院接受手术治疗的OVCF患者107例作为研究对象,其中62例行经皮椎体成形术(PVP)作为PVP组,45例行经皮椎体后凸成形术(PKP)作为PKP组,比较两组手术时间、术中出血量、骨水泥注入总量、术后第3天、6个月及12个月VAS评分、并发症发生率、椎体前缘高度、Cobb角及Oswestry功能障碍指数(ODI)。结果PVP组手术时间和术中出血量分别为(29.24±4.53)min、(14.25±4.49)ml,优于PKP组的(37.18±5.13)min、(19.16±5.60)ml,差异有统计学意义(P<0.05);两组骨水泥注入量比较,差异无统计学意义(P>0.05)。PVP组和PKP组在术后各时间点VAS评分均低于术前(P<0.05),但组间比较,差异无统计学意义(P>0.05)。PVP组术前及术后椎体前缘高度比较,差异无统计学意义(P>0.05),而PKP组术后各时间点椎体前缘高度高于术前和PVP组,差异有统计学意义(P<0.05)。两组术后各时间点Cobb角均较术前减小,且PKP组小于PVP组,差异有统计学意义(P<0.05)。两组术后各时间点ODI小于术前,且术后第3个月、第12个月ODI均小于术后第3天,差异有统计学意义(P<0.05),但组间术后各时间点ODI比较,差异无统计学意义(P>0.05)。PVP组骨水泥渗漏和椎体骨折发生率分别为25.81%、9.68%,与PKP组的17.78%、8.89%比较,差异无统计学意义(P>0.05)。结论PVP和PKP均能有效治疗OVCF,PKP能复位压缩椎体高度,帮助患者恢复脊柱生理曲线,但手术时间长、难度大,而PVP则能在更短的时间内完成骨水泥注射。因此,临床医生应结合患者具体情况并灵活选择最适的手术方式。Objective To explore the clinical efficacy of two bone cement injection techniques in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods A collection of 107 patients with OVCF who underwent surgical treatment in our hospital from January 2014 to January 2017 were collected as the research objects.Among them,62 patients underwent percutaneous vertebroplasty(PVP)as the PVP group,45 cases underwent percutaneous kyphoplasty(PKP)as the PKP group,the operation time,intraoperative blood loss,total amount of bone cement injection,VAS scores at 3 days,6 months and 12 months after surgery,complication rate,anterior vertebral height,Cobb angle,and Oswestry dysfunction were compared between the two groups Index(ODI).Results The operation time and peri-operative bleeding of PVP group(29.24±4.53)min,(14.25±4.49)ml was better than that of PKP group(37.18±5.13)min,(19.16±5.60)ml,with signifcant difference(P<0.05),but there was no significant difference between these two groups in the volume of bone cement(P>0.05).The VAS scores of the PVP group and the PKP group were lower at all time points after the operation than before the operation(P<0.05),but there was no statistically significant difference between the groups(P>0.05).There was no significant difference in the anterior vertebral height between preoperative and postoperative in PVP group(P>0.05),but the anterior vertebral height of PKP group was higher than that of preoperative and PvP groups at each time point after operation,and the difference was statistically significant(P<0.05),as shown in Table 4.Cobb angle of the two groups at each time point after operation was decreased,and PKP group was smaller than PVP group,the difference was statistically significant(P<0.05),as shown in Table 5.ODI at each time point after operation was lower than that before operation,and ODI at 3 months and 12 months after operation was less than that at 3 days after operation(P<0.05),but there was no significant difference in ODI at each time point between the tw

关 键 词：骨质疏松 椎体压缩性骨折 经皮椎体成形术 经皮椎体后凸成形术 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]