摘要
目的比较经皮椎体成形术(PVP)与保守法治疗老年骨质疏松性胸腰椎压缩骨折的疗效。方法选择2009年7月—2010年10月我院收治的老年骨质疏松性胸腰椎压缩骨折患者38例,采用随机数字表法并结合患者自身要求分为对照组(17例)和治疗组(21例),分别采用保守法和PVP进行治疗。比较两组患者治疗前后疼痛视觉模拟评分(VAS评分)、椎体高度及Cobb角、椎体再骨折情况。结果对照组和治疗组组内治疗前、治疗后1周、治疗后1个月、末次随访时VAS评分比较,差异均有统计学意义(P<0.05);组间同期比较,仅治疗后1周时VAS评分差异有统计学意义(P<0.05)。两组患者治疗前椎体前缘、中线、后缘高度及Cobb角比较,差异均无统计学意义(P>0.05);治疗后比较,除椎体后缘高度外,其他指标间差异均有统计学意义(P<0.05)。对照组治疗前后椎体前缘、中线高度及Cobb角比较,差异均有统计学意义(P<0.05);椎体后缘高度比较,差异无统计学意义(P>0.05)。治疗组治疗前后椎体前缘、中线、后缘高度及Cobb角比较,差异均无统计学意义(P>0.05)。对照组有2例、治疗组有4例患者出现椎体再骨折。结论 PVP止痛效果显著且持久,但较难恢复椎体高度,术后椎体再骨折发生率较高;保守法治疗止痛周期较长,椎体高度恢复情况较好,术后椎体再骨折发生率较低。
Objective To compare the clinical effect of percutaneous vertebroplasty （PVP） with that of conservative therapy in treatment of elderly osteoporotic thoracolumbar vertebral compression fractures. Methods A total of 38 elderly osteo- porotic patients with thoracolumbar vertebral compression fracture admitted from July 2009 to October 2010 were divided randomly into groups control （n =17, given conservative therapy） and therapy （n =21, given PVP）. The visual analog scale （VAS） , vertebral height and Cobb＇s angle, vertebral refracture occurrence were compared in 2 groups before and after treatment. Results There was significant difference in VAS between 2 groups before treatment, 1 week and 1 month after treatment, during the last follow - up （P 〈 0. 05）, and between groups in the same period 1 week after treatment （P 〈 0.05 ）. No difference was not- ed in heights of vertebral anterior, midline , posterior borders or Cobb＇s angle between 2 groups before treatment （P 〉 0.05 ）, but there was except in height of vertebral posterior border after treatment （ P 〈 0.05 ）. There was difference in height of verte- bral anterior, midline borders and Cobb＇s between pre - and post - treatment in control group （P 〈 0. 05）, but there was no in vertebral anterior border height （P 〉 0. 05）. There was no difference in height of anterior, midline, posterior or Cobb＇s angle between pre - and post - treatment in therapy group （ P 〉 0. 05 ）. Two from control group, 4 from therapy group had vertebral refractures. Conclusion PVP has remarkable and lasting analgesic effect but is more difficult to restore vertebral height with higher incidence of refractures ; Conservative therapy has longer analgesic effect and vertebral height recovered better with lower incidence of vertebral refractures after treatment.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第14期1629-1632,共4页
Chinese General Practice
基金
洛阳市科技发展计划项目(1201051A-4)
