经皮椎体成形术联合阿仑膦酸钠治疗绝经后妇女骨质疏松性椎体压缩性骨折的短期疗效  

Short-term efficacy of PVP combined with alendronate sodium in the treatment of osteoporotic vertebral compression fracture in postmenopausal women

作　　者：潘伟城 谭志斌 谢广渊 PAN Weicheng;TAN Zhibin;XIE Guangyuan(Department of Orthopaedics II,Dalang Hospital of Dongguan,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞市大朗医院骨二科,广东523000

出　　处：《中国骨科临床与基础研究杂志》2020年第4期222-227,共6页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探究经皮椎体成形术(PVP)联合阿仑膦酸钠治疗绝经后妇女骨质疏松性椎体压缩性骨折(OVCF)的近期效果。方法回顾性分析2018年4月—2019年10月东莞市大朗医院120例OVCF绝经后女性患者的临床资料,患者均采用PVP手术。根据是否联合阿仑膦酸钠治疗分为对照组和观察组(n=60),对照组口服碳酸钙及骨化三醇,观察组在对照组基础上口服阿仑膦酸钠。比较两组伤椎高度、视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、血清Ⅰ型前胶原氨基端前肽(P1NP)和β-Ⅰ型胶原羧基端肽(CTX)水平,同时观察骨密度及不良反应发生情况。结果两组术后不同时相点伤椎椎体高度及腰痛VAS评分、ODI较术前有所改善,手术前后比较,差异具有统计学意义(P<0.05)。观察组术后3、6个月VAS、ODI评分及血清P1NP、β-CTX水平均较对照组有所改善,术后再次骨折发生率低于对照组(P<0.05);两组腰椎骨密度和不良反应发生率相似(P>0.05)。结论PVP联合阿仑膦酸钠可有效缓解绝经后妇女OVCF伤椎疼痛症状,提高胸腰椎功能,降低再骨折风险,近期疗效良好。Objective To explore the short-term efficacy of percutaneous vertebroplasty(PVP)combined with alendronate sodium in the treatment of osteoporotic vertebral compression fracture(OVCF)in postmenopausal women.Methods Clinical data of 120 postmenopausal women with OVCF who performed PVP in Dalang Hospital of Dongguan from April 2018 to October 2019 were retrospectively analyzed.The patients were divided into control group and observation group(n=60)according to whether combined with treatment of alendronate sodium.In control group,patients were given calcium carbonate and calcitriol only,while in observation group,patients were given alendronate sodium on the basis of the treatment in control group.The height of injured vertebrae,visual analogue scale(VAS)score,Oswestry disability index(ODI),serum levels of procollagen 1 N-terminal propeptide(P1 NP)andβ-C-terminal telopeptide of type I collagen(β-CTX),bone mineral density(BMD),as well as complications were compared between the two groups.Results The height of injured vertebre,VAS score and ODI at different time points after the operation were improved when compared with the preoperative ones,which showed statistical differences between preoperation and postoperation(P<0.05).At 3,6 months postoperatively,VAS score,ODI,and serum P1 NP andβ-CTX levels in observation group were better than those in control group,incidence of re-fracture complications was also lower than that in control group(P<0.05).BMD and incidence of adverse reactions were similar in two groups(P>0.05).Conclusion For OVCF in postmenopausal women,PVP combined with alendronate sodium can effectively relieve the pain of injured vertebrae,improve thoracolumbar spinal functions,reduce the risk of re-fracture,and obtain good short-term efficacy.

关 键 词：骨质疏松 绝经后 脊柱骨折 椎体成形术 二磷酸盐类 骨生成 骨质吸收 骨密度 

分 类 号：R683.2[医药卫生—骨科学] R687[医药卫生—外科学]