摘要
目的 研究经皮骨水泥椎间盘成形术(PCD)在椎体骨质疏松性骨折治疗中的临床疗效。方法 120例椎体骨质疏松性骨折患者,根据治疗方法不同分为PCD组和PVP组,每组60例。PCD组采用PCD治疗,PVP组采用经皮椎体成形术(PVP)治疗。比较两组患者手术切口长度、手术时间、出血量、骨水泥量、骨水泥渗漏发生情况、住院时间、手术前后的腰部视觉模拟评分法(VAS)评分、手术前后的日本骨科协会评估治疗(JOA)评分。结果 PCD组手术切口长度(3.1±1.1)mm、手术时间(34.0±10.2)min、住院时间(2.13±0.21)d均短于PVP组的(10.3±2.1)mm、(52.1±9.91)min、(4.13±0.77)d,出血量(3.34±2.12)ml少于PVP组的(15.15±5.91)ml,术后2 h腰部VAS评分(2.15±0.21)分低于PVP组的(4.21±0.20)分,术后2 h的JOA评分(24.17±0.94)分高于PVP组的(21.15±0.96)分,骨水泥渗漏发生率8.33%低于PVP组的23.33%,差异均具有统计学意义(P<0.05)。两组注射的骨水泥量、术前及末次随访的腰部VAS评分及JOA评分比较,差异均无统计学意义(P>0.05)。两组术后2 h以及末次随访腰部VAS评分和JOA评分与术前比较,差异均具有统计学意义(P<0.05)。结论 PCD治疗椎体骨质疏松性骨折具有与PVP相同的效果,且具有明显的手术切口长度小、时间短、出血量少、住院时间短、骨水泥渗漏少等优点。
Objective To study the clinical efficacy of percutaneous cemented discoplasty(PCD)in the treatment of osteoporotic vertebral fracture.Methods A total of 120 patients with osteoporotic vertebral fracture were divided into PCD group and PVP group according to different treatment methods,with 60 cases in each group.The PCD group was treated with PCD,and the PVP group was treated with percutaneous vertebroplasty(PVP).Both groups were compared in terms of incision length,operation time,blood loss,amount of bone cement,occurrence of bone cement leakage,hospitalization time,and visual analogue scale(VAS)score of the waist,and the Japanese Orthopaedic Association(JOA)score before and after the surgery.Results The incision length(3.1±1.1)mm,operation time(34.0±10.2)min and hospitalization time(2.13±0.21)d of the PVP group were shorter than(10.3±2.1)mm,(52.1±9.91)min and(4.13±0.77)d of the PVP group,the blood loss(3.34±2.12)ml was less than(15.15±5.91)ml of the PVP group,the waist VAS score(2.15±0.21)points at 2 h postoperatively was lower than(4.21±0.20)points of the PVP group,JOA score(24.17±0.94)points at 2 h postoperatively was higher than(21.15±0.96)points of the PVP group,and the incidence of bone cement leakage 8.33%was lower than 23.33%in the PVP group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the amount of bone cement injected,the waist VAS score and JOA score before the surgery and at the last follow-up between the two groups(P>0.05).The waist VAS score and JOA score at 2 h postoperatively and the last follow-up in the two groups were statistically significant compared with those before the surgery(P<0.05).Conclusion PCD has the same effect as PVP in the treatment of osteoporotic vertebral fractures,and has the advantages of small incision length,short time,less blood loss,short hospitalization time and low cement leakage.
作者
陶伟伟
朱建非
TAO Wei-wei;ZHU Jian-fei(Department of Spine Surgery,Huai’an Medical District of Eastern Theater General Hospital,Huai’an 223001,China)
出处
《中国实用医药》
2021年第31期1-5,共5页
China Practical Medicine
