摘要
目的探讨椎体后凸成形术（percutaneous kyphoplasty,PKP）中骨水泥弥散容积率在评价骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture,OVCF）患者术后疗效中的应用。方法回顾性分析2013年1月至2014年12月,我院收治的105例OVCF患者,其中男36例,女69例,平均年龄（74.70±9.69）岁。均为新鲜单椎体压缩骨折,骨折时间平均（6.82±5.26）天,采用经皮穿刺PKP注入骨水泥治疗;术中透视下每个椎体注入约1.5~6.0 ml聚甲基丙烯酸甲酯骨水泥,平均为（2.80±0.41）ml/椎。术前、术后72 h记录疼痛视觉模拟评分（visual analogue scale,VAS）、Barthel指数评定量表（barthel activities of daily living index,BI）评分。术后CT测量骨水泥注射体积、骨水泥弥散体积及骨折椎体体积,观察骨水泥向椎体外渗漏率。将本组105例骨水泥弥散容积率与术前、术后症状改善程度（VAS评分改善、BI指数评分改善）做相关性分析检验。按骨水泥弥散容积率（v）的大小分为小剂量组（v≤0.1）,中剂量组（0.125%）并不能增加疗效,反而可能会增加骨水泥渗漏风险。
Objective To observe the application of bone cement defused volume rate in evaluating therapeutic effects of osteoporotic vertebral compression fracture（ OVCF） patients with percutaneous kyphoplasty（ PKP）. Methods From January 2013 to December 2014, 105 patients were of osteoporotic vertebral compression fractures that were all fresh, single vertebral fractures, including 36 male cases and 69 female cases with the mean age of（ 74.70 ± 9.69） years old. All patients were treated with PKP. The average time of fracture was（ 6.82 ± 5.26） days. Each vertebra was injected 1.5- 6.0 ml polymethylmetacrylate（ PMMA） bone cement, and the average was（ 2.80 ± 0.41） ml. The visual analogue scale（ VAS） score and Barthel activities of daily living index（ BI） were observed before and after the operation for 72 hours. Injected bone cement volume, defused bone cement volume and vertebra volume were measured with computer tomography（ CT）. Leakage rate of bone cement was also observed with CT. A correlation analysis of bone cement defused volume with symptom score, including VAS and BI, was conducted. According to the rate of defused bone cement volume（ v）, 105 cases were divided into 3 groups： low-dosage group（ v ≤ 0.1）; mid-dosage group（ 0.1〈 v 〈0.2）; high-dosage group（ v ≥ 0.2）. A comparative analysis in treatment effects among 3 groups including pain score and BI score were carried out. Results All 105 patients were treated by bilateral transpedicular PKP successfully. Bone cement in the vertebra was distributed symmetrically, and bone cement defused volume ratio ranged from 0.08 to 0.38, average 0.15 ± 0.05. Bone cement leakage occurred in 5 cases. All of the 5 cases were from high-dosage group, which was the highest in bone cement defused volume rate showing no clinical symptoms. VAS scores and BI scores were better than that before the operation. Pain was relieved or disappeared, and functions of daily activities were improved. Preoperative VAS score： low-dosag
出处
《中国骨与关节杂志》
CAS
2016年第1期68-73,共6页
Chinese Journal of Bone and Joint
基金
国家卫计委(椎体成形术临床应用研究)第二期课题资助项目(W2013ZT0022)
北京市卫生系统高层次人才("215"高层次卫生技术人才队伍建设工程)项目
北京市东城区科技计划项目(2013-3-007)
