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不同穿刺方向的椎體成形術(shù)治療老年骨質(zhì)疏松椎體壓縮性骨折的療效對(duì)比

發(fā)布時(shí)間:2018-03-01 21:25

  本文關(guān)鍵詞: 椎體成形術(shù) 骨水泥滲漏 穿刺方法 骨質(zhì)疏松 出處:《中國(guó)老年學(xué)雜志》2017年16期  論文類型:期刊論文


【摘要】:目的比較不同穿刺方向的椎體成形術(shù)(PVP)治療老年骨質(zhì)疏松椎體壓縮性骨折的臨床療效。方法老年骨質(zhì)疏松椎體壓縮性骨折行PVP治療188例(214節(jié)椎體),根據(jù)不同的穿刺方向分為3組,A組為經(jīng)椎弓根向椎體上1/3方向穿刺,B組為向中1/3方向穿刺,C組為下1/3方向穿刺,對(duì)所有患者進(jìn)行術(shù)前1 d、術(shù)后1 d、1 w的疼痛視覺(jué)模擬評(píng)分(VAS),術(shù)前及術(shù)后1 w進(jìn)行功能障礙(ODI)評(píng)分,術(shù)后復(fù)查X線片及CT檢查評(píng)估骨水泥滲漏率。結(jié)果 3組VAS及ODI評(píng)分術(shù)前、術(shù)后比較差異有統(tǒng)計(jì)學(xué)意義(P0.01),但各組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。A組穿刺法與其他兩組骨水泥滲漏率比較有明顯統(tǒng)計(jì)學(xué)意義(P0.01),B、C組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),同一穿刺方向的椎體球囊擴(kuò)張后凸成形術(shù)(PKP)法與PVP法比較差異有明顯統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論經(jīng)椎弓根向椎體上1/3穿刺進(jìn)針?lè)较蛐蠵VP治療老年骨質(zhì)疏松壓縮性骨折可以有效減少骨水泥的滲漏,且無(wú)論哪種進(jìn)針?lè)较騊KP較PVP骨水泥滲漏率低。
[Abstract]:Objective to compare the clinical effects of vertebroplasty with different puncture directions in the treatment of senile osteoporotic vertebral compression fractures. Methods PVP was performed in 188 patients with osteoporotic vertebral compression fractures. The puncture direction was divided into 3 groups. Group A was punctured through pedicle to the upper vertebral body in 1/3 direction. Group B was punctured in the middle and 1/3 directions. Group C was punctured in the lower 1/3 direction. All patients were assessed with visual analogue score of pain 1 day before operation, visual analogue score of pain 1 week after operation, dysfunction score before and 1 week after operation. The rate of bone cement leakage was evaluated by X-ray and CT examination after operation. Results the VAS and ODI scores were evaluated before and after operation. The difference was statistically significant (P 0.01), but there was no significant difference between the two groups. There was no significant difference in the leakage rate of bone cement between group A and the other two groups. There was no significant difference in the leakage rate of bone cement between group A and the other two groups. There was no significant difference between group A and group C (P 0.05%), but there was no significant difference between group A and group A (P 0.05%) in the same puncture direction. There was significant difference between kyphoplasty and PVP in the treatment of senile osteoporotic compression fractures. Conclusion PVP can effectively reduce the leakage of bone cement through the pedicle of vertebrae to the 1/3 puncture needle to the upper vertebral body in the treatment of osteoporotic compression fractures in the elderly. The leakage rate of PKP was lower than that of PVP.
【作者單位】: 福建醫(yī)科大學(xué)附屬南平第一醫(yī)院骨科;
【分類號(hào)】:R687.3

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