PKP治疗骨质疏松性多节段椎体压缩性骨折的临床疗效

doi:10.6040/j.issn.1671-7554.0.2014.304

摘要/Abstract

摘要： 目的观察与评价经皮穿刺椎体后凸成形术(PKP)治疗多节段骨质疏松性椎体压缩性骨折(OVCF)的临床疗效.方法 2009年1月至2013年12月多节段OVCF患者68例,其中17例(共49椎体)为保守组,行绝对卧床保守治疗,51例(共121椎体)为手术组,接受PKP手术治疗,两组患者均行同样的抗骨质疏松治疗.两组患者通过临床及影像学资料,采用Barthel指数、Cobb角测量、模拟视觉评分(VAS)及Oswesty功能障碍指数(ODI),评价两组临床效果差异,评估PKP的治疗效果.结果 68例患者获随访12～24个月(平均18.6月),手术组术后24 h内疼痛症状均有明显缓解或消失.X线片示椎体高度未见明显丢失,未出现严重并发症.手术组在Barthel指数、Cobb角测量、VAS评分及ODI指数的效果评分中,术前与术后3 d、入院后3个月、入院后12个月相比,效果差异较大(P<0.05);手术组与保守组1年后相比,Cobb角测量也同样存在较大的差异(P<0.05);而Barthel指数、VAS评分及ODI指数差异性较小(P>0.05).结论 PKP是多节段骨质疏松性椎体压缩性骨折的有效治疗方法,可靠性和安全性较高,具有较高的临床价值.

关键词: 临床疗效, 经皮穿刺椎体后凸成形术, 骨质疏松性椎体压缩性骨折

Abstract: Objective To observe and evaluate the therapeutic effect of percutaneous kyphoplasty (PKP) on osteoporotic multi-compressive fracture (OVCF). Methods A retrospective study was conducted on 68 OVCF cases during Jan. 2009 to Dec. 2013. The control group (n=17, 9 vertebrae) was treated with strict-in-bed method, while the surgical group (n=51, 121 vertebrae) was treated with PKP. In addition, the two groups received the same anti-osteoporosis treatment. The clinical and radiological parameters of the two groups were compared, including Barthel index, Cobb angle, visual analogue scale/score (VAS) and Oswesty disability index (ODI). Results After a follow-up of 12～24 months (average 18.6 months), the data indicated that the pain of 51 cases was significantly released or even eradicated 24 hours after surgery. X-ray images showed no obvious bone loss or severe complications. There was significant statistic difference (P<0.05) in Barthel Index, Cobb angle, VAS and ODI in the surgical group before and 12 months after the PKP surgery. There was marked difference (P<0.05) between the surgical group and control group in Cobb Angle one year after PKP surgery (P<0.05). Conclusion PKP is safe and effective to treat osteoporotic multi-Compressive fracture.

Key words: Therapeutic effect, Percutaneous kyphoplasty, Osteoporotic compressive fracture

中图分类号:

R683.2

樊庆凯, 龚维明, 宁斌, 宋宏亮, 蔚建鲁, 贾堂宏. PKP治疗骨质疏松性多节段椎体压缩性骨折的临床疗效[J]. 山东大学学报（医学版）, 2014, 52(11): 73-76.

FAN Qingkai, GONG Weiming, NING Bin, SONG Hongliang, WEI Jianlu, JIA Tanghong. Therapeutic effect of percutaneous kyphoplasty on osteoporotic multi-compressive fracture[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(11): 73-76.

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