老年骨质疏松伴椎体压缩骨折患者保守治疗的效果观察  

Effects of bone strengthening treatment for elderly patients with osteoporosis and vertebral compression fracture

作　　者：张彦彦 于慧春[1] 李广[2] ZHANG Yanyan;YU Huichun;LI Guang(Department of Geriatry,Tianjin Xiqing Hospital,Tianjin 300380,China;Department of Spinal Surgery,Tianjin People's Hospital,Tianjin 300191,China)

机构地区：[1]天津市西青医院老年病科,天津300380 [2]天津市人民医院脊柱外科,天津300191

出　　处：《济宁医学院学报》2024年第4期286-289,共4页Journal of Jining Medical University

基　　金：天津市卫生健康科技项目(TJWJ2023QN041)。

摘　　要：目的评估骨质疏松伴椎体压缩骨折患者保守健骨治疗的临床效果及预防再次骨折的效果。方法收集自2020年6月至2022年6月在天津市西青医院老年病科住院的骨质疏松伴椎体压缩骨折患者,进行回顾性对照研究。共收集符合标准的患者71例,根据患者的治疗方案分两组,对照组(32例)仅接受常规口服碳酸钙D片治疗;观察组(39例)接受碳酸钙D片+骨化三醇胶囊+阿仑膦酸片治疗。采用视觉模拟评分(VAS)评估疼痛程度,采用ODI功能障碍指数评估功能障碍情况。比较两组术前及末次随访时的骨密度值、VAS评分、ODI评分,记录两组患者不良反应发生率。结果末次随访时,观察组骨密度值与对照组治疗前后的差值对比为0.4±1.3 vs-0.2±1.0(t=1.785,P=0.023);两组患者的疼痛均有改善,但VAS评分差值无统计学意义(-3.4±1.3 vs-2.9±1.7;t=-0.042,P=-0.742);观察组ODI差值为(-40.3±12.7)分,对照组差值为(-14.2±13.8)分,两组间比较有统计学意义(t=-3.155,P<0.001)。对照组新发椎体骨折发生率为15.6%(5/32),观察组发生率仅为2.6%(1/39);观察组中6例患者口服健骨药物后出现上腹痛,恶心消化道症状,指导患者正确用药后,症状明显缓解。结论联合应用钙片、骨化三醇和阿仑膦酸健骨治疗有助于增加患者骨密度,坚持健骨治疗,对预防椎体再次骨折效果明显。Objective This study was aimed to evaluate the effectiveness of bone strengthening treatment for elderly patients with osteoporosis vertebral compression fracture.Method A retrospective control study was conducted to collect patients with osteoporosis and vertebral compression fractures who were hospitalized in the Geriatrics Department of Xiqing Hospital in Tianjin from June 2020 to June 2022.A total of 71 eligible patients were collected,and the patients were divided into two groups based on their treatment plans.The control group only received conventional oral calcium carbonate D tablets;while the observation group received a combination of calcium carbonate D tablets,calcitriol capsules,and alendronate tablets.The pain intensity was evaluated using the Visual Analog Scale(VAS),and the degree of dysfunction was assessed using the Oswestry Disability Index(ODI).The study was designed to compare the difference of BMD,VAS scores and ODI scores between the two groups before surgery and at the last follow-up,and record the incidence of secondary fractures and adverse reactions in both groups.Result At the last follow-up,the difference in bone mineral density(BMD)values between the observation group and the control group before and after treatment was 0.4±1.3 vs-0.2±1.0(t=1.785,P=0.023).Both groups experienced pain improvement,but the difference in VAS scores was not statistically significant(-3.4±1.3 vs-2.9±1.7;t=-0.042,P=-0.742).When comparing the difference in ODI scores,the observation group had a score of-40.3±12.7,while the control group had a score of-14.2±13.8(t=-3.155,P<0.001).The incidence of new vertebral fractures in the control group was 15.6%(5/32),while that in the observation group was only 2.6%(1/39).In the observation group,6 patients experienced upper abdominal pain and nausea.After proper guidance on medication usage,the symptoms were significantly alleviated.Conclusion The combined use of Calcium tablets,Calcitriol and Alendronic Acid was in favor of increasing bone density and improve so

关 键 词：骨质疏松 骨质疏松伴椎体压缩骨折 健骨治疗 椎体成形术 

分 类 号：R683[医药卫生—骨科学]