摘要
目的:探讨骨质疏松性椎体压缩性骨折患者行手术治疗后椎体再骨折与术后抗骨质疏松治疗及药物依从性的关系。方法:以2018年6月~2020年6月广西医科大学第一附属医院收治的老年骨质疏松性椎体压缩性骨折行手术治疗后,能定期随访的患者103例为研究对象,收集患者术后是否遵医嘱进行抗骨质疏松治疗,用药种类,用药持续时间,是否规律用药,有无药物副作用,停止用药的原因。是否出现腰背部疼痛,影像学检查有无新的骨折等。按术后1年有无椎体再骨折分成两组,比较两组抗骨质疏松治疗的用药差异,筛选出椎体再骨折与抗骨质疏松治疗之间的相关因素,并分析用药的合理性及药物依从性。结果:随访12~24个月,平均13.8个月。其中18例术后1年内发生椎体新发骨折,占随访患者的17.48%。骨折组(85例)以及再骨折组(18例)患者年龄、性别比较差异无统计学意义(P>0.05)。两组在钙剂和维生素D及衍生物的用药持续时间上差异有统计学意义(P<0.05)。两组在双膦酸盐、降钙素、中成药等的用药持续时间上差异无统计学意义(P>0.05)。骨折组抗骨质疏松治疗主要用钙剂和维生素D及衍生物分别为36.4%及34.1%,再骨折组分别为66.7%及16.7%;两组双膦酸盐使用率不到20%,骨折组为15.3%,再骨折组为16.7%。两组药物依从性均比较差,骨折组服用钙剂和维生素D及衍生物超过3个月为34.1%,再骨折组为16.7%。结论:骨质疏松性椎体压缩性骨折患者行椎体成形术后再骨折的发生,与钙剂和维生素D及衍生物的用药持续时间有关,骨质疏松性椎体压缩性骨折患者行椎体成形术后抗骨质疏松治疗不规范,药物依从性差,有必要开展多学科“骨折联络服务”,以规范抗骨质疏松治疗,减少再骨折的发生。
Objective To investigate the relationship between vertebral refracture and postoperative anti-osteoporosis treatment and drug compliance of patients with osteoporotic vertebral compression fracture after vertebroplasty.Method 103 cases of symptomatic elderly patients with osteoporotic vertebral compression fracture admitted to our hospital from June 2018 to June 2020 who underwent PVP or PKP and could be regularly followed up were selected as the research objects.The patients were collected whether they followed the doctor′s advice for anti-osteoporosis treatment,the type and duration of medication,whether they used drugs regularly,whether they had side effects,and the reasons for stopping medication.Whether there is low back pain,imaging examination for new fractures,etc.they were divided into two groups according to whether there was vertebral refracture or not one year after operation.The differences of anti-osteoporosis treatment between the two groups were compared and statistically analyzed to screen out the related factors between vertebral refracture and anti-osteoporosis treatment,and analyze the rationality of drug use and drug compliance.Results All patients were followed up 12~24 months,with an average of 13.8 months.Among them,18 patients developed new vertebral fractures within 1 year after operation,accounting for 17.48%of the follow-up patients.There was no significant difference in age and gender between the fracture group(85 cases)and the refracture group(18 cases)(P>0.05).There were statistically significant differences in the duration of calcium and vitamin D and derivatives between 2 groups(P<0.05).There was no significant difference in the duration of bisphosphonate,calcitonin and Chinese patent medicine between 2 groups(P>0.05).Calcium and vitamin D and derivatives were mainly used for anti-osteoporosis treatment in the two groups,fracture group(36.4%,34.1%,respectively)and refracture group(66.7%,16.7%,respectively).Bisphosphonate utilization was less than 20%in both groups and 15.3%in the fracture group and 16.7%in the refracture group.Medication compliance was poor in both groups,with 34.1%of patients taking calcium and vitamin D and derivatives for more than 3 months in the fracture group and 16.7%in the refracture group.Conclusion The incidence of refracture after vertebroplasty in patients with osteoporotic vertebral compression fractures is associated with the duration of calcium and vitamin D and derivatives.Anti-osteoporosis treatment for patients with osteoporotic vertebral compression fractures after vertebroplasty is not standardized and drug compliance is poor.Therefore,it is necessary to carry out multidisciplinary"fracture liaison service"to standardize anti-osteoporosis treatment and reduce the occurrence of refractures.
作者
宫德峰
吴昊
刘冲
曾浩
GONG De-feng;WU Hao;LIU Chong(Spinal Osteopathy Surgery,The First Affiliated Hospital Of Guangxi Medical University,Nanning 530021,China)
出处
《吉林医学》
CAS
2023年第9期2409-2413,共5页
Jilin Medical Journal
基金
广西壮族自治区卫生健康委员会资助项目[合同编号:Z20200895]。
关键词
骨质疏松性椎体压缩性骨折
椎体成形术
椎体再骨折
药物依从性
骨折联络服务
Osteoporotic vertebral compression fracture
Percutaneous vertebroplasty
Vertebral Refracture
Drug compliance
Fracture Liaison Service
