椎体成形术联合高电压脉冲及射频消融术治疗椎体压缩骨折的临床研究  

Percutaneous vertebroplasty combined with high voltage pulse and radiofrequency ablation in the treatment of vertebral compression fractures

作　　者：王杰伟 李阳[2] 杨屾[1] 臧鹏 王志鹏[2] Wang Jiewei;Li Yang;Yang Shen;Zang Peng;Wang Zhipeng(The Fourth Department of Orthopedics(Department of Neck-Shoulder-Waist-Leg Pain Medicine),Beijing Changping Hospital of Integrated Chinese and Western Medicine,Beijing City 102208,China;Office of Doctor Patient Disputes,Beijing Changping Hospital of Integrated Chinese and Western Medicine,Beijing City 102208,China)

机构地区：[1]北京市昌平区中西医结合医院骨四科(颈肩腰腿疼痛科),北京102208 [2]北京市昌平区中西医结合医院医患办,北京102208

出　　处：《中华疼痛学杂志》2024年第2期258-264,共7页Chinese Journal Of Painology

摘　　要：目的探索椎体成形术(PVP)联合高电压脉冲及射频消融治疗椎体压缩骨折的临床效果。方法收集2019年2月至2021年11月北京市昌平区中西医结合医院骨四科住院的椎体压缩骨折患者92例。根据治疗方式不同,分为联合治疗组(PHF组,n=22)、射频消融组(PF组,n=24)、高电压射频组(PH组,n=24)和单纯PVP组(PVP组,n=22)。PHF组患者采用PVP联合高电压脉冲调节及射频消融治疗,PF组采用PVP联合靶点射频消融治疗,PH组采用PVP联合高电压脉冲调节,PVP组只采用PVP治疗。分别于治疗前,治疗后2 d,1、2、8、14个月评估并比较患者的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)及日常生活活动能力评定量表(ADL)。并于治疗后14个月时,根据疼痛缓解程度评估比较4组患者的镇痛效果。观察并记录手术并发症发生情况。结果4组患者一般情况比较,差异无统计学意义(P>0.05)。与治疗前比较,所有患者治疗后各评价时点的VAS与ODI评分均降低,ADL评分均升高,差异均有统计学意义(P均<0.05)。治疗后14个月时,4组间镇痛效果比较差异均无统计学意义(P均>0.05)。治疗后14个月时,与PH、PVP两组比较,PHF、PF两组VAS、ODI评分下降更为明显,差异均有统计学意义(P均<0.05),ADL评分升高更为明显,差异具有统计学意义(P均<0.05)。各组患者手术并发症比较差异均无统计学意义(P均>0.05)。结论PVP联合高电压脉冲及射频消融术是一种安全有效的治疗椎体压缩骨折治疗方法,且疗效稳定。Objective To explore the clinical effect of percutaneous vertebral plasty,combined with high-voltage pulse and radiofrequency ablation in the treatment of vertebral compression fractures.Methods Ninety-two patients with vertebral compression fractures admitted to the Fourth Department of Orthopedics,Beijing Changping Hospital of Integrated Traditional Chinese and Western Medicine from February 2019 to November 2021 were collected.According to different treatment methods,patients were divided into combination therapy group(PHF group,n=22),radiofrequency ablation group(PF group,n=24),high voltage radiofrequency group(PH group,n=24),and pure PVP group(PVP group,n=22).Patients in the PHF group were treated with PVP combined with high-voltage pulse modulation and radiofrequency ablation.Patients in the PF group were treated with PVP combined with target radiofrequency ablation.Patients in the PH group were treated with PVP combined with high-voltage pulse modulation,while patients in the PVP group were only treated with PVP.The visual analogue scale(VAS),Oswestry disability index(ODI),and ADL(Barthel Index)of patients before the treatment and 2 days,1,2,8,and 14 months after the treatment were assessed and compared.At 14 months after the treatment,the analgesic effects of the four groups of patients based on the degree of pain relief were evaluated and compared.The occurrence of surgical complication was observed and recorded.Results The general situation of the four groups of patients had no statistical difference(P>0.05).Compared with pre-treatment,the VAS and ODI scores of all patients decreased at each evaluation point after the treatment,while the ADL scores increased,and the differences were statistically significant(all P<0.05).At 14 months after the treatment,there was no statistically significant difference in the analgesic effect among the four groups(all P>0.05).At 14 months after the treatment,compared with group PH and PVP,group PHF,PF showed more significant decrease in VAS and ODI,and the differences we

关 键 词：椎体成形术 骨折 压缩性 脊神经 腰痛 骨质疏松症 脉冲 射频消融 

分 类 号：R687.3[医药卫生—骨科学]