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不同经皮微创治疗方法治疗老年胸腰椎骨质疏松性骨折的疗效对比 被引量:6

Comparative study of percutaneous kyphoplasty and percutaneous vertebroplasty in the treatment of thoracolumbar osteoporotic fractures in elderly patients
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摘要 目的探讨经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗老年胸腰椎骨质疏松骨折(OVGF)的近远期疗效及安全性。方法选取2013年1月至2014年6月92例老年OVGF患者为研究对象,根据患者手术方式将其分为PKP组48例和PVP组44例,分别于术前及术后3d、1个月、6个月应用视觉模拟疼痛评分(VAS)对患者疼痛进行评估,采用功能障碍指数评分(ODI)对患者功能障碍进行评价。通过X线计算患者伤椎增加高度、伤椎高度丢失值,同时结合胸片观察患者是否发生骨水泥渗漏。结果PVP组出血量高于PKP组(P〈0.05),骨水泥注入量少于PKP组(P〈0.05),而两组手术时间、x线照射时间、住院时间比较差异未见统计学意义(P〉0.05)。PVP组术后3d、1个月、6个月伤椎增加高度、伤椎中部高度少于PKP组(P〈0.05)。两组术后3d、1个月、6个月VAS评分、ODI评分比较差异未见统计学意义(P〉0.05),术后下肢静脉栓塞、邻椎骨折发生率比较差异未见统计学意义(P〉0.05),但PKP组骨水泥渗漏率低于PVP组(P〈0.05)。结论PVP与PKP术均能有效改善老年OVGF患者腰椎功能,减轻患者疼痛感。但PKP复位效果优于PVP术,骨水泥渗漏发生率较低,临床可优先选择PKP治疗老年OVEF。 Objective To investigate the short and long-term effect and safety of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) in the treatment of elderly patients with thoracolumbar osteoporotic fracture (OVGF). Methods From January 2013 to June 2014, 92 elderly patients with OVGF were selected, they were divided into PKP group (48 cases ) and PVP group (44 cases) according to the different treatment methods. The pain was assessed by visual analog pain scale (VAS) and the functional disability index score was evaluated by ODI before surgery and 3 d, 1 month, 6 months after operation. The increased height of injured vertebra and the value of vertebral height loss were observated with X-ray, and the occurrence of bone cement leakage were observed at the same time. Results In PVP group, the amount of bleeding were higher than those in PKP group (P 〈 0. 05 ), the bone cement injected was less than that in PKP group (P 〈 O. 05 ), while the operative time, X-ray irradiation time, hospitalization time of two groups had no significant differences ( P 〉 0.05 ). The increased height of injured vertebra, the height of middle part of the injured vertebra of PVP group were lower than those of PKP group 3 d, 1 month and 6 months after operation( P 〈0.05 ). The VAS scores, ODI score of the two group had no significant differences 3 d, 1 month and 6 months after operation ( P 〉 0.05 ). The incidences of venous thrombosis and adjacent vertebral fractures after operation had no significant differences ( P 〉 0. 05 ), but the bone cement leakage rate of PKP group was less than that of PVP group ( P 〈 0. 05 ). Conclusions PVP and PKP can effectively improve the lumbar function in elderly patients with OVGF, relieve patient' s pain. However, the effect of PKP is better than that of PVP, and the incidence of bone cement leakage is low. The clinical treatment of elderly patients with OVGF may prefer PKP.
出处 《中国实用医刊》 2017年第6期50-53,共4页 Chinese Journal of Practical Medicine
关键词 经皮椎体后凸成形术 经皮椎体成形术 老年 胸腰椎骨质疏松骨折 疗效 Percutaneous kyphoplasty Percutaneous vertebroplasty Elderly Thoracolumbar osteoporotic fractures Efficacy
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