过伸加压复位法联合经皮穿刺椎体成形术治疗老年骨质疏松新鲜椎体压缩性骨折疗效观察  

Curative effect of overextension and compression reduction combined with percutaneous vertebroplasty in the treatment of fresh vertebral compression fractures

作　　者：袁伶俐[1] 徐文弟[1] 耿春辉[1] 朱勋兵[1] 张仲传 白建中 YUAN Lingli;XU Wendi;GENG Chunhui;ZHU Xunbing;ZHANG Zhongchuan;BAI Jianzhong(Department of Osteology,the Second Affiliated Hospital of Bengbu Medical College,Bengbu 23300,Anhui Province,China)

机构地区：[1]蚌埠医学院第二附属医院骨科,安徽蚌埠233000

出　　处：《新乡医学院学报》2020年第12期1152-1155,共4页Journal of Xinxiang Medical University

基　　金：蚌埠医学院自然科学重点课题(编号:BYKY2019134ZD)。

摘　　要：目的探讨过伸加压复位法联合经皮穿刺椎体成形术(PVP)治疗老年骨质疏松新鲜椎体压缩性骨折的临床效果。方法选择2018年11月至2019年11月蚌埠医学院第二附属医院骨科收治的老年骨质疏松新鲜椎体压缩性骨折患者40例为研究对象,按随机数字表法将患者分为过伸加压复位法联合PVP组(联合PVP组)和PVP组,每组20例。联合PVP组患者行过伸加压复位方法联合PVP手术,PVP组患者行传统PVP手术。比较2组患者手术总时间、手术过程中X线透视次数、骨水泥填充量、住院时间、治疗费用、疼痛视觉模拟评分(VAS)(术后第2天及术后3、6个月)、Cobb角、中线高度压缩率、骨水泥渗漏及邻近椎体骨折发生率。结果联合PVP组患者X线透视次数、骨水泥填充量显著高于PVP组(P<0.05);联合PVP组患者手术总时间、Cobb角、中线高度压缩率、治疗费用低于PVP组(P<0.05)。2组患者住院时间比较差异无统计学意义(P>0.05)。术后第2天及术后3、6个月,联合PVP组患者的VAS评分均显著低于PVP组(P<0.05)。联合PVP组患者发生骨水泥渗漏1例(5%),邻近椎体骨折2例(10%);PVP组患者发生骨水泥渗漏2例(10%),邻近椎体骨折3例(15%);联合PVP组与PVP组患者骨水泥渗漏、邻近椎体骨折发生率比较差异无统计学意义(χ2=0.280、0.110,P>0.05)。结论过伸加压复位法联合PVP治疗老年骨质疏松性新鲜椎体压缩性骨折能够促进椎体高度和Cobb角恢复,增加骨水泥注入量,是一种安全、可行的手术方式。Objective To explore the clinical effect of overextension and compression reduction combined with percutaneous vertebroplasty(PVP)in the treatment of fresh vertebral compression fracture in elderly patients with osteoporosis.Methods Forty elderly patients with osteoporosis and vertebral compression fracture in the Department of Osteology,the Second Affiliated Hospital of Bengbu Medical College from November 2018 to November 2019 were selected as research objects,and they were randomly divided into overextension and compression reduction combined with PVP group(combination PVP group)and PVP group,with 20 patients in each group.The patients in the combination PVP group were treated with overextension compression reduction combined with PVP,and the patients in the PVP group were treated with traditional PVP.The total operation time,intraoperative fluoroscopy times,bone cement filling volume,hospitalization time,treatment cost,visual analogue scales(VAS)score at 2 days and 3,6 months after operation,Cobb′s angle,midline high compression ratio,bone cement leakage and adjacent vertebral fracture ratio were compared between the two groups.Results The times of fluoroscopy and the bone cement filling volume of patients in the combination PVP group were significantly higher than those in the PVP group(P<0.05).The operation time,Cobb′s angle,midline high compression ratio and treatment cost of patients in the combination PVP group were significantly lower than those in the PVP group(P<0.05).There was no statistical difference in the hospitalization time of patients between the two groups(P<0.05).The VAS scores of patients in the combination PVP group was significantly lower than that in the PVP group at 2 days and 3,6 months after operation(P<0.05).In the combination PVP group,there were 1 case(5%)of bone cement leakage and 2 cases(10%)of adjacent vertebral fractures;in the traditional PVP group,there were 2 cases(10%)of bone cement leakage and 3 cases(15%)of adjacent vertebral fractures;there was no statistical differe

关 键 词：过伸加压复位法 椎体高度 经皮穿刺 椎体成形术 新鲜椎体压缩性骨折 

分 类 号：R683.2[医药卫生—骨科学]