不同手术时机经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的效果比较  

Comparison of the effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures at different operative times

作　　者：刘飚[1] 宁奉盛 肖勇 朱令孝[1] 易立人 LIU Biao;NING Fengsheng;XIAO Yong;ZHU Lingxiao;YI Liren(Department of Orthopedics,Ji'an Central People's Hospital,Jiangxi Province,Ji'an343000,China)

机构地区：[1]江西省吉安市中心人民医院骨科,江西吉安343000

出　　处：《中国当代医药》2023年第32期61-64,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140985)。

摘　　要：目的比较不同手术时机经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折的效果。方法回顾性分析2020年1月至2021年3月吉安市中心人民医院骨科收治的因骨质疏松性椎体压缩性骨折行PKP治疗的60例患者的病历资料,根据不同手术时机将其分为研究组(n=30)与对照组(n=30),研究组患者在骨折发生1周内进行手术治疗,对照组患者在骨折发生1~2周进行手术治疗。比较两组患者术前、术后的骨折恢复情况,包括伤椎后凸角、伤椎高度压缩率,统计两组骨水泥渗漏率,评估两组患者术前、术后的疼痛改善情况[视觉模拟量表(VAS)]以及功能改善情况[Oswestry功能障碍指数(ODI)]。结果术前,两组患者VAS、ODI评分比较,差异无统计学意义(P>0.05);术后,两组患者VAS、ODI评分均低于本组术前,且研究组患者VAS、ODI评分均低于对照组,差异有统计学意义(P<0.05);术前,两组患者伤椎高度压缩率、伤椎后凸角比较,差异无统计学意义(P>0.05)。术后,两组患者伤椎高度压缩率低于本组术前,伤椎后椎凸角小于本组术前,且研究组患者伤椎高度压缩率低于对照组,伤椎后凸角小于对照组,差异有统计学意义(P<0.05)。观察组骨水泥渗漏率高于对照组,差异有统计学意义(P<0.05)。结论PKP可有效缓解患者骨质疏松性椎体压缩性骨折胸腰疼痛症状,促进椎体功能恢复,具有较高的安全性。Objective To compare the effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures at different operation times.Methods The medical records of 60 patients who underwent percutaneous kyphoplasty for osteoporotic vertebral compression fracture admitted to the Department of Orthopedics of Ji'an Central People's Hospital from January 2020 to March 2021 were retrospectively analyzed,and they were divided into study group(30 cases)and control group(30 cases)according to different operation times.Patients in the study group received surgical treatment within 1 week of fracture occurrence,and patients in the control group received surgical treatment within 1 to 2 weeks of fracture occurrence.Fracture recovery before and after surgery,including kyphotic angle and high compression ratio of the injured vertebra,bone cement leakage rate of the two groups were compared,and preoperative and postoperative pain improvement(visual analogue scale[VAS])and functional improvement(Oswestry disability index[ODI])of the two groups were evaluated.Results Before surgery,there were no significant differences in VAS and ODI scores between two groups(P>0.05).After surgery,VAS and ODI scores in two groups were lower than those before surgery,and VAS and ODI scores in study group were lower than those of control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in the compression rate of vertebral height and kyphosis angle between two groups(P>0.05).After surgery,the compression rates of wound vertebral height in two groups were lower than those before surgery,and the kyphosis angle of injured vertebral were lower than those before surgery,the compression rate of wound vertebral height in the study group was lower than that of the control group,the kyphosis angle of injured vertebral was lower than that of the control group,the differences were statistically significant(P<0.05).The bone cement leakage rate of study group was higher than t

关 键 词：骨质疏松性椎体压缩性骨折 经皮椎体后凸成形术 手术时机 疼痛 肢体功能 

分 类 号：R683[医药卫生—骨科学]