摘要
目的:探究经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折的长期随访效果.方法:选取2016年1月-2017年11月本院收治的骨质疏松性椎体压缩骨折患者80例.按照不同的手术治疗方法将其分为PVP组与PKP组,每组40例.比较两组围术期指标、手术前后VAS评分、椎体压缩率、伤椎Cobb角度及术后6个月内的不良反应发生情况.结果:两组均顺利通过手术,手术过程中并未出现血管或神经方面的损伤.PVP组手术时间短于PKP组,骨水泥注入量少于PKP组,差异均有统计学意义(P<0.05).两组手术后1、6个月VAS评分均低于手术前,且手术后6个月VAS评分低于手术后1个月.手术前、手术后1、6个月,两组VAS评分比较,差异均无统计学意义(P>0.05).手术后6个月及手术后1年,两组椎体压缩率及伤椎Cobb角度均较手术前减少,手术后1年,两组椎体压缩率及伤椎Cobb角度均较手术后6个月减少.手术后6个月及手术后1年,PVP组椎体压缩率及伤椎Cobb角度均高于PKP组,差异均有统计学意义(P<0.05).PVP组不良反应发生率为17.50%,高于PKP组的2.50%,差异有统计学意义(P<0.05).对两组出现不良反应的患者给予对症处理后,均得到明显缓解,无严重并发症的出现.随访结果显示两组疼痛、活动及生活自理方面比较,差异均无统计学意义(P>0.05).结论:PVP与PKP治疗骨质疏松性椎体压缩骨折均有较高的止痛效果,但并未表现出明显的差异.长期随访发现,PKP在术后伤椎高度及椎体压缩率方面比PVP改善更为明显,且术后并发症发生率较低,安全性更高.
Objective:To explore the long-term follow-up effect of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures.Method:A total of 80 patients with osteoporotic vertebral compression fracture admitted to our hospital from January 2016 to November 2017 were selected.They were divided into PVP group and PKP group according to different surgical treatment methods,40 cases in each group.The perioperative indexes,VAS score,vertebral compression rate and Cobb angle before and after operation and adverse reactions within 6 months after operation were compared between the two groups.Result:Both groups passed the surgery without any vascular or neurological damage.The operation time of PVP group was shorter than that of PKP group,the amount of bone cement injected was less than that of PKP group,the differences were statistically significant(P<0.05).VAS score at 1 and 6 months after surgery were lower than those of before surgery,and VAS score at 6 months after surgery was lower than that at 1 month after surgery.Before surgery,1 and 6 months after surgery,comparison of VAS scores between the two groups,the differences were not statistically significant(P>0.05).At 6 months after surgery and 1 year after surgery,the vertebral body compression rate and Cobb Angle of injured vertebrae in both groups decreased compared with that before surgery.At 1 year after surgery,the vertebral body compression rate and Cobb Angle of injured vertebrae in two groups decreased compared with that at 6 months after surgery.At 6 months after surgery and 1 year after surgery,the vertebral compression rate and Cobb Angle of injured vertebrae in PVP group were higher than those in PKP group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in PVP group was 17.50%,higher than 2.50%in PKP group,the difference was statistically significant(P<0.05).After symptomatic treatment,the patients with adverse reactions in the two groups were significantly relieved without serious complications.The follow-up results showed that there were no significant difference between the two groups in terms of pain,activity and self-care(P>0.05).Conclusion:PVP and PKP have higher analgesic effect in the treatment of osteoporotic vertebral compression fracture,but there was no significant difference.Long-term follow-up showes that PKP is more significantly improved than PVP in terms of postoperative vertebral height and vertebral compression rate,and the incidence of postoperative complications is lower and the safety is higher.
作者
王国寿
陈泽群
邝立鹏
王德伟
谭伟源
WANG Guoshou;CHEN Zequn;KUANG Lipeng;WANG Dewei;TAN Weiyuan(The Fifth Affiliated Hospital(Zhuhai)of Zunyi Medical University,Zhuhai 519100,China)
出处
《中国医学创新》
CAS
2020年第18期23-28,共6页
Medical Innovation of China
基金
贵州省卫生计生委科学技术基金项目(gzwjkj2016-1-006)。
关键词
经皮椎体成形术
经皮椎体后凸成形术
骨质疏松
椎体压缩骨折
Percutaneous vertebroplasty
Percutaneous kyphoplasty
Osteoporosis
Vertebral compression fracture
