摘要
目的对经皮穿刺椎体(后凸)成形术(PVP/PKP)联合抗骨质疏松治疗与保守联合抗骨质疏松治疗老年人骨质疏松性压缩骨折的长、短期疗效做回顾性分析并比较二者疗效。方法回顾性分析于2014年1月至2017年12月在我院诊断为骨质疏松性椎体压缩骨折的115例患者,年龄65~91岁,平均(76±7)岁,按其治疗的方法不同,分为手术联合抗骨质疏松治疗组(手术组73例)和保守联合抗骨质疏松治疗组(保守组42例)。手术组采用PVP或PKP手术,术后次日起1年规律应用抗骨质疏松药物。保守组采用绝对卧床休息,口服非甾体抗炎止痛药物,同时自次日起规律应用抗骨质疏松治疗。应用视觉模拟评分法(VAS)分别对手术组手术前和术后次日的疼痛感进行评价,对保守组治疗前和服药后次日的疼痛感进行评价。应用日本骨科协会评估治疗分数(JOA评分)分别对2组治疗前、治疗后3个月和治疗后1年的腰椎功能进行评价。应用双能X线骨密度仪分别检测2组治疗前和治疗1年后腰椎骨密度(BMD)和T值进行测量和评价。分析并比较2种方法的疗效。结果2组治疗后次日VAS评分均较治疗前显著降低(P<0.05),但手术组治疗后VAS评分更低。手术组与保守组比较,治疗前VAS评分差异无统计学意义(P>0.05);治疗后次日,手术组VAS评分较保守组显著降低(P<0.05)。手术组和保守组治疗后3个月、1年JOA评分均较治疗前显著升高(P<0.05);治疗后3个月与1年的JOA评分比较,手术组差异无统计学意义(P>0.05),而保守组差异有统计学意义(P<0.05)。手术组治疗后3个月的JOA评分较保守组明显升高(P<0.05),而治疗后1年手术组与保守组的JOA评分差异无统计学意义(P>0.05)。2组治疗后1年BMD和T值均较各自治疗前明显升高(P<0.05),治疗前及治疗后1年,2组的BMD和T值比较差异均无统计学意义(P>0.05)。结论PVP/PKP对缓解疼痛、改善脊柱功能等方面的作用优于保守治�
Objective To investigate the efficacy of percutaneous vertebroplasty/kyphoplasty(PVP/PKP)vs conservative treatment in combination with anti-osteoporotic medications for treating osteoporotic vertebral compression fractures(OVCFs)in the elderly.Methods Retrospectively included were 115 patients diagnosed with OVCFs in our hospital between January 2014 and December 2017.The patients,aged 65 to 91 years,mean(76±7)years,were divided into two groups based on treatment methods,to undergo surgery combined with anti-osteoporotic medications(surgical group,n=73)or remain on conservative treatment combined with anti-osteoporotic medication(conservative group,n=42).The surgical group underwent PVP or PKP,and remained on regular use of anti-osteoporotics for one year starting from the next day after surgery.The conservative group was treated with absolute bed rest,oral non-steroidal anti-inflammatory drugs,and the one-year regular use of anti-osteoporotics starting from the next day.Visual analogue scale(VAS)was used to evaluate the pain for the surgical group before and on the next day after surgery,and for the conservative group before and on the next day of treatment.Japanese Orthopedic Association score(JOA score)was applied to evaluate the lumbar spine function of the two groups before,at 3 months and 1 year after treatment.Bone mineral density(BMD)and BMD T-score were measured and evaluated by dual-energy X-ray absorptiom-etry.The efficacy of the two treatment options was compared and analyzed.Results The VAS score in the two groups on the next day after treatment was significantly lower than that before treatment(P<0.05)and the reduction was greater in the surgical group than that in the conservative group.The VAS score before treatment did not significantly differ between the two groups(P>0.05)and was significantly lower in the surgical group than that in the conservative group on the next day after treatment(P<0.05).In either group,the JOA scores were significantly higher at 3 months and 1 year than those before tr
作者
郭娜
荣青峰
Guo Na;Rong Qingfeng(Seond Division,Department of Geriatrics,Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中国药物与临床》
CAS
2020年第20期3368-3372,共5页
Chinese Remedies & Clinics
关键词
椎体成形术
保守治疗
骨质疏松性骨折
骨密度
Vertebroplasty
Conservative treatment
Osteoporotic fractures
Bone density
