摘要
目的:比较不同骨水泥注入量在经皮椎体成形术中治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)的效果。方法:选取2014年1月-2018年3月笔者所在医院收治的121例骨质疏松性椎体压缩骨折患者为研究对象,依据临床用药剂量的不同,分为高剂量组(n=41)、中剂量组(n=38)和低剂量组(n=42),三组高黏度骨水泥的注入量分别为9、6、3 ml。术前、术后7 d、术后12个月时,用视觉模拟评分法(VAS)评估疼痛情况,用Oswestry功能障碍指数(ODI)评估运动功能。术前、术后1 d、术后3个月时用CT测量伤椎椎体高度和Cobb角。记录随访期间骨水泥渗漏情况。结果:治疗后三组VAS评分、ODI评分均明显改善(P<0.05),但是组间差异均无统计学意义(P>0.05)。治疗后三组伤椎椎体高度和Cobb角均明显改善(P<0.05),术后7 d和术后12个月时,高剂量组伤椎椎体高度高于中剂量组和低剂量组,高剂量组Cobb角低于中剂量组和低剂量组(P<0.05)。低剂量组骨水泥渗漏率均低于中等剂量组和高剂量组(P<0.05)。结论:在临床治疗中,高剂量组有着较好的伤椎椎体高度和Cobb角,但是在骨水泥渗漏率方面依旧存在着较高的渗漏率,相比之下,经皮椎体成形术中应用低剂量的高黏度骨水泥,在达到满意临床疗效的同时,可以降低骨水泥渗漏。
Objective:To compare the effect of different amount of bone cement injection in the treatment of osteoporotic vertebral compression fractures(OVCF)during percutaneous vertebroplasty.Method:A total of 121 patients with osteoporotic vertebral compression fractures admitted to the hospital from January 2014 to March 2018,were selected as subjects.According to the clinical dose,they were divided into the high-dose groups(n=41),the middle dose group(n=38)and the low dose group(n=42),the injection volumes of the three groups of high-viscosity bone cement were 9,6,and 3 ml,respectively.Pain was assessed by visual analog scale(VAS)before surgery,7 days after surgery,and 12 months after surgery,and motor function was assessed using the Oswestry Disability Index(ODI).The height of the injured vertebral body and the Cobb angle were measured by CT before operation,1 day after surgery and 3 months after operation.The bone cement leakage during follow-up was recorded.Result:After treatment,the VAS score and ODI score of the three groups were significantly improved(P<0.05),but there was no significant difference among the three groups(P>0.05).After treatment,the vertebral height and Cobb angle of the injured vertebrae in the three groups were significantly improved(P<0.05).At 7 days and 12 months after operation,the vertebral height of the injured vertebrae in the high dose group was higher than that in the middle dose group and the low dose group,and the Cobb angle in the high dose group was lower than that in the middle dose group and the low dose group(P<0.05).The leakage rate of bone cement in low dose group was lower than that in medium dose group and high dose group(P<0.05).Conclusion:In the clinical treatment,the high-dose group has a good vertebral body height and Cobb angle,but there is still a high leakage rate in the bone cement leakage rate.In contrast,the percutaneous vertebral body low-dose high-viscosity bone cement is used in angioplasty to reduce bone cement leakage while achieving satisfactory clinical results.
作者
汪天喜
WANG Tianxi(Xiantao Traditional Chinese Medicine Hospital,Xiantao 433000,China)
出处
《中外医学研究》
2019年第34期51-53,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
骨质疏松性椎体压缩骨折
高黏度骨水泥
经皮椎体成形术
Osteoporotic vertebral compression fracture
High viscosity bone cement
Percutaneous vertebroplasty
