手法整复联合垫枕法对经皮椎体成形术影响的效果评价  

The effect of manipulative reduction plus pillow cushion on percutaneous vertebroplasty

作　　者：宋海波[1] 王剑锋[1] 刘宏[2] SONG Haibo;WANG Jianfeng;LIU Hong

机构地区：[1]海宁市中医院,浙江海宁314400 [2]浙江省立同德医院,浙江杭州310000

出　　处：《中医临床研究》2021年第30期122-125,共4页Clinical Journal Of Chinese Medicine

基　　金：浙江省嘉兴市2017年科技计划项目、海宁市科技局项目(2017BY18097)。

摘　　要：目的:探讨术前手法整复联合垫枕法对椎体成形术治疗骨质疏松性胸腰椎骨折效果的影响。方法:2017年10月-2018年10月海宁市中医院收治的骨质疏松性胸腰椎骨折患者50例,随机分为对照组(24例)及治疗组(26例),治疗组术前行中医手法整复联合垫枕法,对照组术前不进行此项训练。分别记录两组术前、术后腰背部疼痛视觉模拟评分法(Visual Analogue Score,VAS)评分,椎体后凸畸形角Cobb角,伤椎高度恢复情况,骨水泥灌注量。结果:①术前两组患者VAS评分比较,差异无统计学意义[(8.36±0.68),(8.59±0.74),Z=-0.178,P=0.890];术后3 d治疗组VAS评分与术前对比差异有统计学意义[(1.66±0.73),Z=-6.422,P=0.000],术后3 d对照组VAS评分与术前对比差异有统计学意义[(1.94±0.82),Z=-6.132,P=0.000];两组对腰背部疼痛的改善效果相同[(7.11±0.69),(7.15±0.78),Z=-0.436,P=0.660]。②术前两组患者Cobb角组间对比,差异无统计学意义[(24.33±11.96),(23.76±10.88),t=0.321,P=0.742];术后3 d治疗组Cobb角与术前对比差异有统计学意义[(11.94±4.82),t=16.482,P=0.000],术后3 d对照组Cobb角与术前对比差异有统计学意义[(14.11±5.43),t=12.161,P=0.000];治疗组改善脊柱后凸畸形优势更明显[(13.36±5.12),(11.25±5.89),t=2.288,P=0.026]。③术前两组患者伤椎前缘高度组间对比,差异无统计学意义[(16.33±1.46),(16.56±1.78),t=0.577,P=0.793];术后3 d治疗组伤椎前缘高度与术前对比差异有统计学意义[(29.76±4.22),t=4.481,P=0.000],术后3 d对照组伤椎前缘高度与术前对比差异有统计学意义[(26.92±4.14),t=3.167,P=0.000];治疗组治疗方式恢复伤椎前缘高度效果更好[(13.71±1.56),(10.65±1.43),t=2.251,P=0.023]。④两组骨水泥灌注量比较,差异有统计学意义[(4.89±0.23),(3.82±0.19),t=6.571,P=0.000]。结论:术前进行中医手法整复联合垫枕法可明显提高经皮椎体成形术患者的临床效果,能最大限度恢复椎体高度和纠正椎体后�Objective:To explore the effect of preoperative manipulative reduction plus pillow cushion on osteoporotic thoracolumbar fractures treated with vertebroplasty.Methods:50 patients with osteoporotic vertebral compression fracture treated in TCM Hospital of Haining,Zhejiang from Oct.2017 to Oct.2018 were randomly divided into the control group(24 cases)and the treatment group(26 cases).The treatment group was treated with traditional Chinese medicine manipulation plus pillow cushion before operation while the control group received no manipulation like this before operation.The preoperative and postoperative back pain VAS score,kyphosis Cobb angle,anterior vertebral height and bone cement perfusion volume were compared between the two groups.Results:①There was no significant difference in VAS scores between the two groups before operation[(8.36±0.68),(8.59±0.74),Z=-0.178,P=0.890].There was a significant difference in VAS score between before treatment and 3 days after operation in the treatment group[(1.66±0.73),Z=-6.422,P=0.000].There was a statistically significant difference in VAS score between before and 3 days after operation in the iontrol group[(1.94±0.82),Z=-6.132,P=0.000].The two groups had the same effect on the pain of the back[(7.11±0.69),(7.15±0.78),Z=-0.436.P=0.660].②There was no significant difference in Cobb angle between the two groups before operation[(24.33±11.96),(23.76±10.88),t=0.321,P=0.742].Three days after operation,the Cobb angle in the treatment group was significantly different from that before operation[(11.94±4.82),t=16.482,P=0.000].There was a significant difference in Cobb angle between the treatment group and the control group in 3 days after operation[(14.11±5.43),t=12.161,P=0.000].In the treatment group,the advantage of improving kyphosis was more obvious[(13.36±5.12),(11.25±5.89),t=2.288,P=0.026].③There was no significant difference in the anterior edge height of injured vertebrae between the two groups before operation[(16.33±1.46),(16.56±1.78),t=0.577,P=0.793

关 键 词：手法整复 垫枕法 胸腰椎骨折 经皮椎体成形术 

分 类 号：R274.2[医药卫生—中医骨伤科学]