骨质疏松患者经皮椎体成形术后发生骨水泥渗漏的影响因素分析及预防策略  

Analysis of Influencing Factors and Preventive Strategies of Bone Cement Leakage in Patients with Osteoporosis after Percutaneous Vertebroplasty

作　　者：马吉超 MA Jichao(Department of orthopedics,Beijing Chaoyang integrated traditional Chinese and western medicine emergency rescue hospital,Chaoyang,Beijing 100023)

机构地区：[1]北京朝阳中西医结合急诊抢救医院骨一科,北京100023

出　　处：《中国伤残医学》2023年第21期5-9,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨骨质疏松性椎体压缩性骨折(OVCF)患者经皮椎体成形术(PVP)后发生骨水泥渗漏的影响因素,为临床采取相关预防措施提供指导。方法:回顾性分析我院2019年10月-2022年10月收治的OVCF患者118例的临床资料,所有患者均行PVP治疗,统计术后骨水泥渗漏发生情况,并收集患者的临床资料(性别、骨折部位、骨水泥注入量、有无椎体裂隙征、术前有无合并高血压、椎体周壁有无破坏等),经单因素及多因素分析影响PVP术后发生骨水泥渗漏的相关因素。结果:118例行PVP治疗的0OVCF患者中,共有19例术后发生骨水泥渗漏,骨水泥渗漏发生率为16.10%(19/118);单因素分析显示,发生骨水泥渗漏组与未发生骨水泥渗漏组性别、骨折部位、手术节段、手术入路、术前有无合并高血压、术前有无合并糖尿病、骨折新鲜度相比,差异无统计学意义(P>0.05);发生骨水泥渗漏组年龄≥75岁占比为68.42%(13/19)、有椎体裂隙征占比为42.11%(8/19)、骨水泥注入量≥5.5mL占比为73.68%(14/19)、椎体压缩程度为重度占比为57.89%(11/19)、椎体周壁有破坏占比为47.37%(9/19)、骨水泥注射时期为粥状期占比为42.11%(8/19);未发生骨水泥渗漏组年龄≥75岁占比为29.29%(29/99)、有椎体裂隙征占比为14.14%(14/99)、骨水泥注入量≥5.5mL占比为20.20%(20/99)、椎体压缩程度为重度占比为15.15%(15/99)、椎体周壁有破坏占比为21.21%(21/99)、骨水泥注射时期为粥状期占比为12.12%(12/99),组间相比,差异有统计学意义(P<0.05)。由此可见,年龄、有无椎体裂隙征、骨水泥注入量、椎体压缩程度、椎体周壁有无破坏与PVP术后发生骨水泥渗漏有关,差异有统计学意义(P<0.05);Logistic回归分析显示:年龄≥75岁(β=1.654,OR=5.230,95%CI=1.812-15.092)、有椎体裂隙征(β=1.485,OR=4.416,95%CI=1.512-12.898)、骨水泥注入量≥5.5mL(β=2.403,OR=11.060,95%CI=3.563-34.336)、重度椎体压缩(β=2.041,OR=7.70Objective:To explore the influencing factors of bone cement leakage in patients with osteoporotie vertebral compression fracture(OVCF)after pereutaneous vertebroplasty(PVP),and to provide guidance for clinical preventive measures.Methods:of 118 OVCF patients treated with PVP,19 cases had bone cement leakage after operation Results:The incidence of bone cement leakage was 16.10%(19/118);Univariate analysis showed that there was no sgifiant diference in gender,fracture site,surpgial segment,surg-cal approach,preoperative hypertension,preoperative diabete,and fracture freshness between the group with bone cement leakage and the group without bone cement leakage(P>0.05);In the group with bone cement leakage,68.42%(13/19)were aged≥75 years old,42.11%(8/19)were with vertcbral fssure sign,73.68%(14/19)were with bone cement injction volume≥5.5ml,57.89%(11/19)were with severe degree of vertebral copesion,47.37%(9/19)were with destruction of the peripheral wall of the vrtebral body,and 42.11%(8/19)were with poridge during the injection of bone cement;In the group without bone cement leakage,29.29%(29/99)were aged≥75 years old,14.14%(14/99)were with vetebral fssure sign,20.20%(20/99)were with bone cement niee-tion volune≥5.5ml,15.15%(15/99)were with severe degree of vertbral conpression,21.21%(21/99)were with destruction of the peripheral wall of the vertebral body,and 12.12%(12/99)were with prridge stage during the niection of bone cement.The difer ence betwcen the groups was stitically sgificant(P<0.05);It can be seen that age,presence or absence of vertebral fssure sign,amount of bone cement inectin,degree of vertebral compesion,and destrution of vertebral wall are related to the leakage of bone ce-ment after PVP,and the diference is stiticaly significant(P<0.05);Logistic regresion analysis showed that age≥75 years old(β=1.654,OR=5.230,95%CI=1.812-15.092),with vertebral fssure sign(β=1.485,OR=4.416,95%Cl=1.512-12.898),bone cement injection≥5.5ml(β=2.403,OR=11.060,95%CI=3.563-34.336),severe vertebral compre

关 键 词：骨质疏松 椎体压缩性骨折 经皮椎体成形术 骨水泥渗漏 影响因素 预防策略 

分 类 号：R681[医药卫生—骨科学]