PCK对老年骨质疏松性椎体压缩骨折的疗效及对术后并发症、生活质量的影响  

Effect of unilateral percutaneous curved ky phosis on senile osteoporotic vertebral compression fractures and its influence on postoperative complications and quality of life

作　　者：于泊[1] 王建博[2] 任宝[3] 曹天威 黄卓 张利文 YU Bo;WANG Jian-bo;REN Bao;CAO Tian-wei;HUANG Zhuo;ZHANG Li-wen(Operating Room,Afiliated Hospital of Hebei University,Baoding 071000,Hebei,China)

机构地区：[1]河北大学附属医院外科手术室,河北保定071000 [2]河北大学附属医院肝胆外科,河北保定071000 [3]河北大学附属医院骨外科,河北保定071000 [4]河北大学医学部,河北保定071000

出　　处：《广东医学》2023年第5期584-590,共7页Guangdong Medical Journal

基　　金：河北省保定市科技计划项目(2141ZF312)。

摘　　要：目的探讨单侧经皮可弯曲椎体后凸成形术(PCK)治疗老年骨质疏松性椎体压缩骨折(OVCF)的临床疗效以及其对患者术后并发症与生活质量的影响。方法选择2020年1月至2022年3月收治的90例老年OVCF患者作为研究对象,按随机数字表法分成观察组与对照组,每组45例。其中观察组行单侧PCK治疗,对照组行双侧经皮椎体后凸成形术(PKP)治疗。比较两组手术时间、术中出血量、术中透视次数、骨水泥用量和骨水泥分布情况。分别于术前及术后1d、3个月、6个月测量两组伤椎椎体前缘高度和椎体后凸角度(Cobb角);分别于术后1、3、6个月采用视觉模拟量表(VAS)评价受试者疼痛程度,运用Oswestry功能障碍指数(ODI)问卷表评价受检者功能障碍情况,使用36项健康调查简表(SF-36)评估研究对象生活质量状况。术后随访6个月,比较两组骨水泥渗漏发生率与椎体再骨折发生率以及其他手术并发症发生情况。结果观察组手术时间、术中出血量、术中透视次数及骨水泥用量均显著少于对照组(P<0.05),两组骨水泥分布比较差异无统计学意义(P>0.05)。两组术后1d、3个月、6个月伤椎椎体前缘高度均显著高于术前(P<0.05),但组间各时点比较差异无统计学意义(P>0.05)。且两组椎体恢复高度、椎体丢失高度比较差异亦无统计学意义(P>0.05)。两组术后1d、3个月、6个月Cobb角均显著小于术前(P<0.05),但组间各时点比较差异无统计学意义(P>0.05)。且两组Cobb角改善度数、Cobb角丢失度数比较差异亦无统计学意义(P>0.05)。两组术后1、3、6个月疼痛VAS评分、ODI评分均较术前显著降低(P<0.05),但组间各时点比较差异无统计学意义(P>0.05)。两组术后1、3、6个月SF-36中躯体健康总测量(PCS)、心理健康总测量(MCS)评分均较术前显著升高(P<0.05),但组间各时点比较差异无统计学意义(P>0.05)。术后随访6个月,观察组骨水泥渗漏发生率为4Objective To investigate the clinical effect of unilateral percutaneous curved kyphoplasty(PCK)for osteoporotic vertebral compression fractures(OVCF)in the elderly and its influence on postoperative complications and quality of life.MethodsA total of 90 elderly patients with OVCF admitted to our hospital from January 2020 to March 2022 were selected and divided into two groups according to random number table method,with 45 cases in each group.The observation group received unilateral PCK treatment and the control group received bilateral percutaneous kyphoplasty(PKP).Operation time,intraoperative blood loss,intraoperative fluoroscopy times,bone cement dosage and bone cement distribution were compared between the two groups.Anterior margin height and kyphosis angle(Cobb Angle)of the injured vertebrae were measured before surgery and 1 day,3 months and 6 months after surgery.Visual analog scale(VAS)was used to evaluate pain.Oswestry Disability Index(ODI)questionnaire was used to evaluate dysfunction.And 36-jtem Health Survey Brief Form(SF-36)was used to evaluate quality of life.The incidence of bone cement leakage,vertebral refracture and other surgical complications were compared between the two groups at 6 months after the operation.Results The time of operation,the amount of blood loss,the times of fluoroscopy and the amount of bone cement in the observation group were significantly less than those in the control group(P<0.05).There was no significant difference in the cement distribution between the two groups(P>0.05).The height of anterior edge of vertebral body was significantly higher in the two groups 1 day,3 months and 6 months after operation than that before operation(P<0.05);but there was no significant difference between the two groups at each time point(P>0.05).There was no significant difference in recovery height and vertebral body loss height between the two groups(P>0.05).The Cobb angles 1 day,3 months and 6 months after operation in both groups was significantly lower than that before operation(

关 键 词：经皮可弯曲椎体后凸成形术 穿刺入路 经皮椎体后凸成形术 骨质疏松性椎体压缩骨折 并发症 生活质量 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]