基于中医"急则治其标"理论指导老年OVCF患者行急诊椎体成形术的临床疗效评价  

Evaluation of the Clinical Effect of Emergency Vertebroplasty in Elderly Patients with OVCF Based on the Theory of"Urgent treatment of Its Standard"of Traditional Chinese Medicine

作　　者：蔡平[1] 周陈西 李东[1] 常志泳 陈印磊 杨挺[1] CAI Ping;ZHOU Chen-xi;LI Dong;CHANG Zhi-yong;CHEN Yin-lei;YANG Ting(Department of Orthopedics,Jiangsu Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu,210029,China)

机构地区：[1]江苏省中医院骨伤科,江苏南京210029

出　　处：《现代生物医学进展》2020年第24期4687-4691,4673,共6页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(818731052);江苏省中医院科技项目(Y20032)。

摘　　要：目的:探讨在中医"急则治其标"理论指导下,为70岁以上老年骨质疏松性椎体压缩骨折(OVCF)患者行急诊椎体成形术的临床疗效和并发症。方法:前瞻性对照研究江苏省中医院2017年1月~2019年12月期间诊断为OVCF行椎体成形术治疗且年龄在70岁以上的59例患者,根据从入院至手术时间分为急诊手术组(n=30)和择期手术组(n=29)。急诊手术组患者为入院当天即安排术前必要检查,以中医"急则治其标"的理论为指导,中西医结合措施干预急性疼痛、高血压、高血糖等应激状态。择期手术组患者入院后常规安排各项检查,常规镇痛,监测并调整血压血糖情况、评估心肺功能,待患者基础病情平稳,入院3天后行椎体成形术治疗,对比两组的临床疗效和并发症。结果:急诊手术组术前住院天数明显少于择期手术组(P<0.05),急诊手术组进入手术室后焦虑自评量表(SAS)低于择期手术组(P<0.05)。急诊手术组术后当天和出院当天数字疼痛评分(NRS)低于择期手术组(P<0.05);急诊手术组术后当天和出院后1个月Oswestry腰椎功能障碍指数(ODI)评分低于择期手术组(P<0.05)。急诊手术组术后Cobb角以及后凸畸形矫正率明显优于择期手术组(P<0.05)。急诊手术组并发症发生率少于择期手术组(P<0.05),满意度优良率高于择期手术组(P<0.05)。结论:坚持"急则治其标"的原则,联合中西医干预措施治疗老年OVCF行急诊椎体成形术患者,能够缓解焦虑情绪,患者术后早期疼痛缓解更明显,腰背功能恢复更满意,术后Cobb角和后凸畸形矫正率改善更好,并发症更少,患者满意度更高。Objective:To investigate the clinical efficacy and complications of emergency vertebroplasty for patients with osteoporotic vertebral compression fracture(OVCF)aged over 70 years under the guidance of the theory of"urgent treatment of its standard"in traditional Chinese medicine.Methods:A prospective,controlled study was conducted on 59 patients aged over 70 who were diagnosed with OVCF and underwent verteboplasty in Jiangsu Hospital of Traditional Chinese Medicine from January 2017 to December 2019.According to the time from admission to operation,the patients were divided into emergency operation group(n=30)and elective operation group(n=29).In the emergency operation group,necessary preoperative examinations were arranged on the day of admission,under the guidance of the theory of"urgent treatment of its standard"in traditional Chinese medicine.Integrated Chinese and western medicine measures to intervene acute pain,hypertension,hyperglycemia and other stress state.Routine examinations were arranged for the patients in the elective operation group after admission,and routine analgesia,monitor and adjust blood pressure and blood sugar,evaluate cardiopulmonary function,the patient’s basic condition was stable,and vertebroplasty was performed 3 days after admission.The clinical efficacy and complications of the two groups were compared.Results:The number of hospitalization days before operation in the emergency operation group was significantly less than that in the elective operation group(P<0.05).Self-RatingAnxiety Scale of the emergency operation group was lower than that of the elective operation group(P<0.05).The digital pain score(NRS)of the emergency operation group on the day after operation and the discharge day were lower than that of the elective operation group(P<0.05).Oswestry lumbar dysfunction index(ODI)score of the emergency operation group on the day after operation and 1 month after discharge were lower than that of the elective operation group(P<0.05).The Cobb Angle after operation and correc

关 键 词：老年人 骨质疏松性椎体压缩骨折 急则治其标 椎体成形术 疗效 

分 类 号：R683[医药卫生—骨科学] R242[医药卫生—外科学]