比较单侧与双侧穿刺PVP对胸腰椎骨质疏松性椎体压缩性骨折患者疼痛程度、影像学指标的影响  

Comparing the Effects of Unilateral and Bilateral PVP Puncture on Pain Degree and Imaging Indexes of Patients with Thoracolumbar Osteoporotic Vertebral Compression Fractures

作　　者：丁坤 刘小双 韩春晓 DING Kun;LIU Xiaoshuang;HAN Chunxiao(Department of Orthopedics,Laixi Third People's Hospital,Qingdao,Shandong,266606,China)

机构地区：[1]莱西市第三人民医院骨科,山东青岛266606

出　　处：《中外医疗》2024年第25期22-25,共4页China & Foreign Medical Treatment

摘　　要：目的探讨单侧与双侧穿刺经皮椎体成形术(percutaneous vertebro plasty,PVP)在胸腰椎骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCFs)中的应用效果。方法方便选取2021年5月—2023年5月莱西市第三人民医院收治的84例胸腰椎OVCFs患者为研究对象,按照穿刺方法分为两组,各42例。两组均行经皮椎体成形术,对照组行双侧穿刺,观察组行单侧穿刺。比较两组手术情况、疼痛程度、日本矫形外科学会腰痛评分表(Japanese Orthopaedic Association Scores,JOA)评分及骨水泥渗漏发生率。结果观察组术中出血量为(28.63±2.85)mL、透视次数为(12.53±1.12)次,少于对照组的(45.63±4.89)mL、(18.41±1.49)次,手术时间为(27.85±2.39)min,短于对照组的(35.87±3.85)min,差异有统计学意义(t=19.465、20.444、11.470,P均<0.05)。观察组术后7 d疼痛评分低于对照组,差异有统计学意义(P<0.05)。两组术后JOA评分中主观症状、临床体征、活动受限程度、总分均高于术前,差异有统计学意义(P均<0.05),但两组相比,差异无统计学意义(P均>0.05)。两组骨水泥渗漏发生率比较,差异无统计学意义(P>0.05)。结论单侧与双侧穿刺PVP均可改善OVCFs患者腰椎功能,但单侧穿刺创伤更轻,可降低术后疼痛,且手术用时短、透视次数少。Objective To investigate the application effect of unilateral and bilateral percutaneous vertebro plasty(PVP)in osteoporotic vertebral compression fractures(OVCFs).Methods A total of 84 patients with thoracolumbar OVCFs admitted to Laixi Third People's Hospital from May 2021 to May 2023 were conveniently selected as the re⁃search objects.According to the puncture method,they were divided into two groups,with 42 cases in each group.Both groups underwent percutaneous vertebroplasty.The control group underwent bilateral puncture,and the observa⁃tion group underwent unilateral puncture.The operation condition,pain degree,Japanese Orthopaedic Association Scores(JOA)score and incidence of bone cement leakage were compared between the two groups.Results The intraop⁃erative blood loss and fluoroscopy times in the observation group were(28.63±2.85)mL and(12.53±1.12)times,which were less than(45.63±4.89)mL and(18.41±1.49)times in the control group,the operation time was(27.85±2.39)min,which was shorter than(35.87±3.85)min in the control group,and the differences were statistically significant(t=19.465,20.444,11.470,all P<0.05).The pain score of the observation group was lower than that of the control group at 7 days after operation,and the difference was statistically significant(P<0.05).The subjective symptoms,clinical signs,degree of activity limitation and total score of JOA score in the two groups were higher than those before opera⁃tion,and the differences were statistically significant(all P<0.05),but there was no significant difference between the two groups after operation(all P>0.05).There was no significant difference in the incidence of bone cement leakage between the two groups(P>0.05).Conclusion Both unilateral and bilateral puncture percutaneous vertebro plasty can improve lumbar function in patients with OVCFs,but unilateral puncture trauma is lighter,which can reduce postop⁃erative time pain,and the operation time is shorter and the fluoroscopy is less.

关 键 词：胸腰椎 骨质疏松性椎体压缩性骨折 单侧穿刺 双侧穿刺 经皮椎体成形术 疼痛程度 

分 类 号：R816.8[医药卫生—放射医学]