PVP/PKP联合唑来膦酸对骨质疏松症压缩性骨折患者治疗效果分析  

Analysis of the therapeutic effects of PVP/PKP combined with zoledronic acid on patients with osteoporosis compression fracture

作　　者：杨元华[1] 田娟娟 蒋天琪 赵志明 YANG Yuanhua;TIAN Juanjuan;JIANG Tianqi;ZHAO Zhiming(Department of Orthopedics,Guyuan People′s Hospital,Guyuan 756000,China;Department of Gastroenterology,Guyuan People′s Hospital,Guyuan 756000,China)

机构地区：[1]宁夏固原市人民医院骨科,宁夏固原756000 [2]宁夏固原市人民医院消化内科,宁夏固原756000

出　　处：《宁夏医学杂志》2024年第4期326-329,共4页Ningxia Medical Journal

摘　　要：目的评估经皮椎体成形术(PVP)/球囊扩张椎体后凸成形术(PKP)联合唑来膦酸治疗骨质疏松症压缩性骨折的疗效,并探讨其对术后再骨折发生率的影响。方法选取110例患骨质疏松症的压缩性骨折患者,分为观察组和对照组,每组各55例。对照组接受PVP/PKP治疗,观察组在此基础上术后给予唑来膦酸静脉滴注。比较2组患者术前、术后1周、术后3个月和术后6个月的Cobb角和椎体前缘高度,评估疼痛程度(VAS),功能障碍,以及血清骨碱性磷酸酶(BALP)、Ⅰ型胶原C端肽(CTX-1)水平和椎体骨密度(BMD),并记录再骨折发生情况。结果观察组患者术后Cobb角显著小于对照组,而椎体前缘高度则显著高于对照组(P<0.05)。观察组患者在术后的VAS评分和功能障碍评分均显著优于对照组(P<0.05)。此外,观察组患者术后3个月和6个月的BALP和CTX-1水平较对照组低,而BMD则较对照组高(P<0.05)。在6个月的随访中,观察组患者的再骨折发生率明显低于对照组。结论PVP/PKP联合唑来膦酸治疗骨质疏松症压缩性骨折能够有效缓解术后疼痛,改善椎体功能,并调节骨代谢,提高骨密度。此外,该联合治疗方案还能有效降低术后再骨折发生率。因此,PVP/PKP联合唑来膦酸可能是一种可行的治疗选择,有助于改善骨质疏松症压缩性骨折的预后。Objective To evaluate the efficacy of percutaneous vertebroplasty(PVP)/balloon kyphoplasty(PKP)combined with zoledronic acid in the treatment of osteoporosis compression fractures and explore the impact on the incidence of subsequent fractures.Methods 110 patients with osteoporosis compression fractures were selected and equally divided into a study group and a control group.The patients in the control group received PVP/PKP treatment,while the patients in the study group received intravenous infusion of zoledronic acid after the procedure.Cobb angle and anterior vertebral height were compared between the two groups before surgery,as well as at 1 week,3 months,and 6 months after surgery.Pain intensity was assessed by using the Visual Analog Scale(VAS),functional disability questionnaire,serum levels of bone alkaline phosphatase(BALP),type I collagen C-terminal telopeptide(CTX-1),and vertebral bone mineral density(BMD)were measured.The occurrence of subsequent fractures was recorded.Results The study group showed significantly smaller Cobb angles and significantly higher anterior vertebral heights than the control group after the procedure(P<0.05).The study group had significantly lower VAS scores and functional disability index scores than the control group after surgery(P<0.05).Additionally,the study group had lower levels of BALP and CTX-1 and higher BMD at 3 months and 6 months after surgery compared to the control group(P<0.05).During the 6-month follow-up,the study group had a significantly lower incidence of subsequent fractures than the control group.Conclusion PVP/PKP combined with zoledronic acid treatment effectively relieves postoperative pain,improves vertebral function,regulates bone metabolism and increases bone density in osteoporosis compression fractures.Furthermore,this combination therapy significantly reduces the incidence of subsequent fractures after surgery.Therefore,the combination of PVP/PKP and zoledronic acid may be a feasible treatment option that can improve the prognosis of compressi

关 键 词：经皮椎体成形术 球囊扩张椎体后凸成形术 唑来膦酸 骨质疏松症 压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]