胸腰椎骨折经皮球囊成形术治疗骨质疏松性胸腰椎骨折效果评价  

Evaluation of the Effect of Percutaneous Balloon Angioplasty for Thoracolumbar Fractures in the Treatment of Osteoporotic Thoracolumbar Fractures

作　　者：张分 方益春 ZHANG Fen;FANG Yichun(Department of Traumatology and Orthopedics,Nanjing Yimin Hospital,Nanjing,Jiangsu Province,211103 China)

机构地区：[1]南京一民医院创伤骨科,江苏南京211103

出　　处：《中外医疗》2022年第2期66-69,共4页China & Foreign Medical Treatment

摘　　要：目的研究经皮球囊成形术(PKP)对骨质疏松胸腰椎骨折患者的疗效、疼痛程度及安全性的影响。方法方便选取解放军第149医院2017年1月—2019年8月及南京一民医院2019年9月—2021年1月收治的60例骨质疏松胸腰椎骨折患者为探究对象,所有患者按抓阄的形式分为经皮组(实施PKP术,30例)与固定组(实施椎弓根螺钉固定术,30例)。观察两组患者的手术效果情况,对比手术前后两组患者疼痛程度评分及Cobb角变化,采用Oswestry功能障碍指数问卷表(ODI问卷)评估两组患者术前、术后1 d时及术后6个月时的腰部功能情况。结果与固定组相比,经皮组的术中出血量、植骨量、手术时间、住院时间更短,差异有统计学意义(P<0.05)。术前两组患者的视觉模拟评分法(VAS)评分、Cobb角指标对比,差异无统计学意义(P>0.05);术后3个月时经皮组患者VAS评分(1.16±0.58)分、Cobb角(7.42±1.33)°均低于固定组的(3.49±1.43)分、(12.64±2.40)°,差异有统计学意义(t=4.240、5.967,P<0.05);术前两组患者ODI评分对比,差异无统计学意义(P>0.05),术后6个月时经皮ODI评分(10.61±3.58)分,显著低于固定组的(12.64±2.74)分,差异有统计学意义(t=2.641,P<0.05);经皮组术后并发症发生率3.33%,显著低于固定组的26.67%,差异有统计学意义(χ^(2)=5.034,P<0.05)。结论PKP能有效治疗骨质疏松性胸腰椎骨折,可显著缓解患者的疼痛程度,促进伤椎生理结构恢复,改善腰部生理功能,安全性较高。Objective To study the effect of percutaneous balloon angioplasty(PKP)on the efficacy,pain degree and safety of patients with osteoporotic thoracolumbar fractures.Methods A total of 60 patients with osteoporotic thoracolumbar fracture treated in PLA 149th Hospital from January 2017 to August 2019 and Nanjing Yimin Hospital from September 2019 to January 2021 were selected as the research subjects.All patients were divided into percutaneous group(performing PKP,30 cases)and fixed group(performing pedicle screw fixation,30 cases)according to the form of lottery.Observed the operation effect of the two groups of patients,and compared the pain degree scores and Cobb angle changes of the two groups before and after the operation.The ODI questionnaire was used to evaluate the waist function before operation,1 d after operation,and 6 months after operation of the two groups of patients.Results Compared with the fixed group,the intraoperative blood loss,bone graft volume,operation time,and hospital stay of the percutaneous group were shorter,and the difference was statistically significant(P<0.05).There was no statistically significant difference in VAS score and Cobb angle index between the two groups of patients before operation(P>0.05).At 3 months postoperatively,the VAS score(1.16±0.58)points and Cobb angle(7.42±1.33)°of the percutaneous group were lower than those of the fixed group(3.49±1.43)points and(12.64±2.40)°,and the difference was statistically significant(t=4.240,5.967,P<0.05).There was no statistically significant difference in ODI scores between the two groups before surgery(P>0.05),and the percutaneous ODI scores at 6 months after surgery were(10.61±3.58)points.It was significantly lower than the(12.64±2.74)points of the fixed group,and the difference was statistically significant(t=2.641,P<0.05).The incidence of postoperative complications in the percutaneous group was 3.33%,which was significantly lower than the 26.67%in the fixed group,and the difference was statistically significant(χ^(2)=5.

关 键 词：经皮球囊成形术 骨质疏松 胸腰椎骨折 临床效果 

分 类 号：R5[医药卫生—内科学]