唑来膦酸联合椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折的临床效果观察  

Clinical effect of Zoledronic Acid combined with Kyphoplasty on osteoporotic thoracolumbar compression fractures

作　　者：张峻玮 曹贞国 李华 魏东 王云清 ZHANG Junwei;CAO Zhenguo;LI Hua;WEI Dong;WANG Yunqing(Department of Spine Surgery,Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006,China)

机构地区：[1]徐州医科大学第二附属医院脊柱外科,江苏徐州221006

出　　处：《医药前沿》2022年第13期11-13,17,共4页Journal of Frontiers of Medicine

摘　　要：目的:探讨唑来膦酸联合椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折(OVCF)的临床效果。方法:选取2019年4月—2021年4月徐州医科大学第二附属医院收治的96例OVCF患者,随机分成观察组与对照组各48例。对照组采取椎体后凸成形术治疗,观察组采取唑来膦酸联合椎体后凸成形术治疗。比较两组患者临床疗效、脊柱后凸角比、椎体压缩率、椎体高度、cobb角、Oswestry功能障碍指数问卷表(ODI)评分、疼痛视觉模拟(VAS)评分、骨钙素、Ⅰ型胶原C端肽水平、骨密度、不良反应发生率与再骨折率。结果:观察组治疗总有效率(95.83%)高于对照组(83.33%),差异有统计学意义(P<0.05)。治疗后,两组的脊柱后凸角比和椎体压缩率均明显降低,且观察组的脊柱后凸角比和椎体压缩率低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组的椎体前缘高度、椎体中部高度、Cobb角比较,差异无统计学意义(P>0.05);治疗后,观察组和对照组的椎体前缘高度、椎体中部高度均增大,Cobb角均减小,且观察组椎体前缘高度、椎体中部高度大于对照组,观察组Cobb角小于对照组,差异均有统计学意义(P<0.05)。治疗后,两组的ODI评分以及VAS评分均明显降低,且观察组的ODI评分以及VAS评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组的骨钙素、Ⅰ型胶原C端肽水平和骨密度均明显降低,且观察组的骨钙素、Ⅰ型胶原C端肽水平和骨密度低于对照组,差异均有统计学意义(P<0.05)。观察组的不良反应发生率(2.08%)低于对照组(14.58%),差异有统计学意义(P<0.05)。结论:唑来膦酸联合椎体后凸成形术治疗OVCF疗效显著,能够有效降低患者不良反应发生率,安全性更高,值得临床应用。Objective To investigate the clinical effect of Zoledronic acid combined with kyphoplasty on osteoporotic thoracolumbar compression fracture(OVCF).Methods 96 patients with OVCF treated in the Second Affiliated Hospital of Xuzhou Medical University from April 2019 to April 2021 were randomly divided into observation group and control group.The control group was treated with Kyphoplasty,and the observation group was treated with Zoledronic acid combined with Kyphoplasty.The clinical efficacy,kyphosis ratio,vertebral compression rate,vertebral height,Cobb angle,Oswestry dysfunction index(ODI)score,pain visual analogue(VAS)score,osteocalcin,type Ⅰ collagen C-terminal peptide level,bone mineral density,adverse reaction rate and re fracture rate were compared between the two groups.Results The effective rate of the observation group(95.83%)was significantly higher than that of the control group(83.33%)(P<0.05).After treatment,the kyphosis ratio and vertebral compression rate of the two groups were significantly reduced.The kyphosis ratio and vertebral compression rate of the observation group were significantly lower than those of the control group(P<0.05).Before treatment,there was no significant difference between the two groups in anterior vertebral height,middle vertebral height and Cobb angle(P>0.05);After treatment,the height of the anterior edge and the middle of the vertebral body in the observation group and the control group increased.The height of the anterior edge and the middle of the vertebral body in the observation group were significantly higher than that in the control group,and the Cobb angle in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the ODI score and VAS score of the two groups decreased significantly.The ODI score and VAS score of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the levels of osteocalcin,C-terminal peptide of type Ⅰ collagen and bone mineral density in the two gro

关 键 词：胸腰椎压缩性骨折 唑来膦酸 椎体后凸成形术 骨质疏松 

分 类 号：R683[医药卫生—骨科学]