经皮椎体成形术Ⅰ期治疗急性多节段老年骨质疏松性胸腰椎压缩骨折  

Percutaneous vertebroplasty for the treatment of acute multi-segment elderly osteoporotic thora-columbar compression fractures

作　　者：李庆达 高林[2] 惠华[2] 贺宝荣[2] 刘团江[2] 杨俊松[2] 章雪芳 郝定均[2] Li Qingda;Gao Lin;Hui Hua(Yan'an University Medical School,Yan'an 716000,China;Lumbar Ward of Spince Hospital,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]延安大学医学院,716000 [2]西安交通大学附属红会医院脊柱病医院腰椎病区,710054

出　　处：《美中国际创伤杂志》2021年第1期24-31,62,共9页U.S.Chinese International Journal of Traumatology

基　　金：国家自然科学基金(81830077,81772357)。

摘　　要：目的:探讨经皮椎体成形术(pereutaneous vertebroplasty,PVP)Ⅰ期治疗手术椎体数>3个的急性多节段老年骨质疏松性椎体压缩骨折(osteoporotie vertebral compression fraetures,OVCFs)的临床疗效。方法:采用回顾性病例对照研究分析2016年10月至2020年2月西安交通大学医学部附属红会医院收治的105例急性多节段老年OVCFs患者临床资料,其中男27例,女78例;年龄65~92岁[(73.0±14.5)岁]。患者均接受Ⅰ期多节段PVP和规范抗骨质疏松治疗。30例手术椎体数>3个(观察组),75例手术椎体数≤3个(对照组)。比较两组手术时间、骨水泥注入量.骨水泥渗漏及再发椎体骨折等并发症情况。比较两组术前、术后1d、1个月及末次随访时的视觉模拟评分(VAS).Oswestry功能障碍指数(ODD和日常生活能力(ADL)评分。结果:患者均获随访11-13个月[(12.5±1.8)个月]。观察组手术时间[(71.2±12.2)min]、术中透视次数[(38.8±6.4)次]骨水泥注入量(20.2±4.6)ml]长或多于对照组[(52.3±10.6)min.(25.4±5.3)次(2.3±4.3)ml](P均<0.05)。骨水泥渗漏和再发椎体骨折情况两组差异无统计学意义(P均>0.05)。无感染、神经损伤及骨水泥植入综合征等并发症发生。术前、术后1 d,术后1个月及末次随访时观察组VAS(7.6±0.7)分、(3.0±0.8)分、(2.3±0.7)、(2.2±0.6)分与对照组[(7.4±0.5)分、(2.9±0.4)分、(2.1±0.5)分、(2.0±0.5)分]比较,差异无统计学意义(P均>0.05);ODI[(74.6±3.3)%、(36.8±4.6)%、(29.7±4.0)%、(24.0±3.6)%]与对照组(73.8±1.0)%、(35.1±0.9)%、(28.4±2.2)%、(22.8±0.9)%]比较,差异无统计学意义(P均>0.05);ADL评分[(34.5±5.0)分、(54.5±3.8)分、(73.7±3.9)分、(80.0±3.9)分]与对照组[(36.2±3.4)分、(56.8±4.7)分、(75.3±5.3)分、(81.3±4.5)分]比较,差异无统计学意义(P均>0.05)。两组VAS.0DI和ADL评分术后各时相点较术前明显改善(P均<0.05)。结论:PVPⅠ期治疗手术椎体数>3个的急性多节段老年OVCFs安全有效,可有效减�Objective:To explore the clinical effect of percutaneous vertebroplasty(PVP)phaseⅠin the treatment of acute multi-segment senile osteoporotic vertebral compression fractures(OVCFs)with more than 3 surgical vertebrae.Methods:A retrospective case-control study was conducted to analyze the clinical data of 105 patients with acute muli-segment OVCFs admitted to our hospital from October 2016 to February 2020.There were 27 males and 78 females,aged 65-92 years,with an average age of(73.0±14.5)years.All patients received stageⅠmulti segmental PVP and standard anti-osteoporosis treatment.There were more than 3 operative vertebral segments in 30 cases(observation group)and less than 3 operative vertebral seg-ments in 75 cases(control group).The operation time,bone cement injection volume,bone cement leakage rate and the incidence of recurrent vertebral fractures were compared between the two groups.Visual ana-logue scale(VAS),Oswestry disability index(ODI)and activity of daily living(ADL)scores were compared before operation,1 day,Ⅰmonth after operation and al the last follow-up.Results:The patients were followed up for 11-13 months[mean(12.5±1.8)months].The operation time of the observation group[(71.2±12.2)min],the number of intraoperative fluoroscopy[(38.8±6.4)times].and the amount of bone cement inference in bone cement leakage and recurring vertebral fractures between the two groups(P>0.05).No complications such as infection,nerve damage,and bone cement implantation syndrome occurred.Before operation,1 day after operation,1 month after operation and at the last follow-up,the observation group's VAS[(7.6±0.7)points,(3.0±0.8)points,(2.3±0.7),(2.2±0.6)points]compared with the control groups[(7.4±0.5)points,(2.9±0.4)points,(2.1±0.5)points,(2.0±0.5)points],the difference was not statistically significant(all P>0.05).ODI[(74.63.3)%,(36.8±4.6)%,(29.7±4.0)%,(24.0±3.6)%]compared with the control group[(73.8±1.0)%,(35.1±0.9)%,(28.4±2.2)%,(22.8±0.9)%],the difference was not statistically significant(P>

关 键 词：老年人 骨质疏松 脊柱骨折 椎体成形术 骨粘合剂 

分 类 号：R68[医药卫生—骨科学]