过伸牵引手法复位联合PVP治疗骨质疏松性椎体压缩骨折的临床效果  

Clinical effect of hyperextension traction manual reduction combined with PVP in the treatment of osteoporotic vertebral compression fractures

作　　者：何宝强 刘颖 张仁杰 史会明[2] 王国柱[3] 周辉 HE Baoqiang;LIU Ying;ZHANG Renjie;SHI Huiming;WANG Guozhu;ZHOU Hui(Yangxian People's Hospital,Hanzhong 723300;Hanzhong Central Hospital,Hanzhong 723000;the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]洋县人民医院,陕西汉中723300 [2]汉中市中心医院,陕西汉中723000 [3]陕西中医药大学第二附属医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2023年第1期35-38,共4页Clinical Research and Practice

基　　金：陕西中医药大学第二附属医院学科创新团队项目(No.2020XKTD-C07)。

摘　　要：目的分析过伸牵引手法复位联合经皮穿刺椎体成形术(PVP)治疗骨质疏松椎体压缩骨折(OVCF)的临床效果。方法选取本院2018年6月至2022年1月收治的420例OVCF患者作为研究对象,根据随机数字表法将其分为对照组与研究组,每组210例。对照组接受PVP治疗,研究组接受过伸牵引手法复位联合PVP治疗。比较两组的手术指标、临床指标、疼痛程度、应激指标、腰椎功能恢复情况。结果研究组的手术用时、X线透视次数、骨水泥填充量、中线高度压缩率、治疗费用均优于对照组(P<0.05)。术后3个月,两组的椎体前缘高度、椎体中部高度均增大,Cobb角均减小,且研究组优于对照组(P<0.05)。研究组术后3 d、1周、3个月、6个月的视觉模拟评分法(VAS)评分低于对照组(P<0.05)。术后3 d,两组的皮质醇(Cor)、去甲肾上腺素(NE)、β-内咖肽(β-EP)、基质金属蛋白酶-3(MMP-3)水平均升高,但研究组低于对照组(P<0.05)。研究组术后3 d、1周、3个月、6个月的Oswestry功能障碍指数(ODI)评分低于对照组(P<0.05)。结论过伸牵引手法复位联合PVP治疗OVCF的临床效果显著,能够减轻机体的应激反应及疼痛症状,还能促进患者术后的腰椎功能恢复,临床可进一步推广应用。Objective To analyze the clinical effect of hyperextension traction manual reduction combined with percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods A total of 420 patients with OVCF admitted in our hospital from June 2018 to January 2022 were selected as the research objects.According to the random number table method,the patients were divided into control group and study group,with 210cases in each group.The control group received PVP treatment,and the study group received hyperextension traction manual reduction combined with PVP treatment.The surgical indexes,clinical indexes,pain degree,stress indexes and lumbar function recovery were compared between the two groups.Results The operation time,X-ray fluoroscopy times,bone cement filling amount,midline height compression rate and treatment cost in the study group were better than those in the control group(P<0.05).Three months after operation,the height of anterior vertebral body and the height of middle vertebral body in the two groups increased,and the Cobb angle decreased,and those in the study group were better than the control group(P<0.05).The Visual Analogue Scale(VAS)score in the study group was lower than that in the control group at 3 d,1 week,3 months and 6 months after operation(P<0.05).Three days after operation,the levels of cortisol(Cor),norepinephrine(NE),beta-endorphin(β-EP)and matrix metalloproteinase-3(MMP-3)in the two groups increased,but those in the study group were lower than the control group(P<0.05).The Oswestry Disability Index(ODI)score in the study group at 3 d,1 week,3 months and 6 months after operation was lower than that in the control group(P<0.05).Conclusion Hyperextension traction manual reduction combined with PVP in the treatment of OVCF has a significant clinical effect,it can reduce the body’s stress response and pain symptoms,and can also promote the recovery of lumbar function after operation,and it can be further promoted and applied in clinic.

关 键 词：骨质疏松性椎体压缩骨折 过伸牵引手法复位 经皮穿刺椎体成形术 

分 类 号：R683.2[医药卫生—骨科学]