单侧椎弓根入路经皮椎体成形术联合唑来膦酸治疗骨质疏松性椎体压缩骨折34例临床观察  

Clinical efficacy of unilateral pedicle approach PVP combined with zoledronic acid in the treatment of osteoporotic vertebral compression fractures

作　　者：薛旭 赵继荣 蒋鹏 张立存 杨文通 杨正汉 赵宁[1] 陈文[1] 张天龙 杨涛 XUE Xu;ZHAO Jirong;JIANG Peng;ZHANG Licun;YANG Wentong;YANG Zhenghan;ZHAO Ning;CHEN Wen;ZHANG Tianlong;YANG Tao(Spinal Diagnosis and Treatment Center,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou,Gansu,730050,China;Clinical College of Chinese Medicine,Gansu University of Chinese Medicine,Lanzhou,Gansu,730101,China;Department of Orthopaedics,Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou,Gansu,730020,China)

机构地区：[1]甘肃省中医院脊柱诊疗中心,甘肃兰州730050 [2]甘肃中医药大学中医临床学院,甘肃兰州730101 [3]甘肃中医药大学附属医院骨科,甘肃兰州730020

出　　处：《甘肃中医药大学学报》2024年第4期44-48,共5页Journal of Gansu University of Chinese Medicine

基　　金：国家重点研发计划(2021YFC1712802);国家中医药管理局专科专病循证能力提升项目(2019XZZX-GK006);甘肃省联合基金重大项目(23JRRA1519);甘肃省科技重大专项(21ZD4FA009);甘肃省自然科学基金项目(23JRRA1248)。

摘　　要：目的观察单侧椎弓根入路经皮椎体成形术(PVP)联合唑来膦酸治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法将68例OVCF患者采用随机数字表法分为对照组和治疗组,各34例。对照组给予PVP治疗,术后给予骨化三醇胶丸联合碳酸钙D3咀嚼片口服;治疗组在对照组治疗方法的基础上给予唑来膦酸静脉滴注。术后3 d比较2组的椎体高度压缩率及Cobb角,术后9个月比较2组的视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分及日常生活活动能力(ADL)评分,术后3,6,9个月比较2组的骨密度(BMD)。结果术后3 d 2组椎体高度压缩率明显降低,Cobb角明显减小,与同组术前比较差异均有统计学意义(P<0.05);术后9个月2组VAS、ODI评分明显降低,ADL评分明显升高,与同组术前比较差异均有统计学意义(P<0.01),且治疗组ODI、ADL评分改善更明显,与对照组术后9个月比较差异均有统计学意义(P<0.05);术后3,6,9个月2组BMD均明显升高,与术前比较差异有统计学意义(P<0.05),且治疗组改善更明显,与对照组同期比较差异均有统计学意义(P<0.05)。结论单侧椎弓根入路PVP联合唑来膦酸能够有效地缓解OVCF患者的临床症状,增加BMD,改善躯体功能障碍,提高生活自理能力,值得临床推广应用。作者:Objective To observe the clinical efficacy of unilateral pedicle approach percutaneous vertebroplasty(PVP)combined with zoledronic acid in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods 68 patients with OVCF were randomly divided into control and treatment groups,with 34 cases in each group.The control group received PVP treatment,followed by oral administration of calcitriol capsules and calcium carbonate D3 chewable tablets.The treatment group received intravenous infusion of zoledronic acid in addition to the treatment method used for the control group.The vertebral height compression ratio and Cobb Angle were compared between the two groups 3 days after surgery,while visual analog scale(VAS)scores,Oswestry Disability Index(ODI)scores,activities of daily living(ADL)scores were compared 9 months after surgery.Bone mineral density(BMD)was also compared at 3,6,and 9 months post-surgery for both groups.Results Three days after operation,significant decreases were observed in the vertebral height compression ratio and Cobb Angle for both groups as compared to pre-surgery measurements(P<0.05).VAS and ODI scores showed significant decreases while ADL scores exhibited significant increases in both groups at the 9-month post-surgery when compared to presurgery values(P<0.01),with more pronounced improvements seen in ODI and ADL scores within the treatment group as opposed to the control group at this time point(P<0.05).BMD increased significantly for both groups at 3,6,and 9 months post-operation when contrasted against pre-operation levels(P<0.05),with more noticeable enhancements noted within the treatment group compared to the control group at the same period(P<0.05).Conclusion Unilateral pedicle approach percutaneous vertebroplasty combined with zoledronic acid can effectively alleviate clinical symptoms associated with OVCF patients,increase BMD,and improve physical dysfunction and selfcare ability,warranting its application in clinical practice.

关 键 词：骨质疏松症 椎体压缩骨折 经皮椎体成形术 唑来膦酸 临床疗效 

分 类 号：R683.2[医药卫生—骨科学]