[1]徐无忌,刘晓岚.体位复位结合经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的对比研究[J].中医正骨,2016,28(07):20-24.
　XU Wuji,LIU Xiaolan.Effect of Qianggu Yin(强骨饮,QGY)on bone microstructure in the ovariectomized osteoporosis rats[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(07):20-24.
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体位复位结合经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年07期
页码:
20-24
栏目:
胸腰椎骨折
出版日期:
2016-07-20

文章信息/Info

Title:
Effect of Qianggu Yin(强骨饮,QGY)on bone microstructure in the ovariectomized osteoporosis rats
作者:
徐无忌; 刘晓岚
湖南中医药大学第二附属医院,湖南 长沙 410005
Author(s):
XU Wuji; LIU Xiaolan
The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410005,Hunan,China
关键词:
脊柱骨折;  骨质疏松性骨折;  骨折; 压缩性;  正骨手法;  椎体成形术;  椎体后凸成形术;  临床试验
Keywords:
spinal fractures;  osteoporotic fractures;  fractures; compression;  bone setting manipulation;  vertebroplasty;  kyphoplasty;  clinical trail
摘要:
目的:比较体位复位结合经皮椎体成形术(percutaneous vertebroplasty,PVP)与经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折的临床疗效及安全性。方法:2009年1月至2014年1月收治175例骨质疏松性椎体压缩骨折患者,其中82例采用体位复位结合PVP治疗(联合治疗组),93例采用PKP治疗(PKP组)。比较2组患者的手术时间、术中透视次数、住院时间、治疗费用、疼痛视觉模拟量表(visual analogue scale,VAS)评分、Cobb's角、邻近椎体骨折发生率和骨水泥渗漏率。结果:联合治疗组的手术时间、术中透视次数、治疗费用均低于PKP组[(30.134±7.503)min,(55.215±12.781)min,t=-16.046,P=0.000;(15.610±1.322)次,(20.366±3.653)次,t=-11.716,P=0.000;(15 078.146±1 149.556)元,(31 659.765±1 662.886)元,t=-77.440,P=0.000]; 2组患者的住院时间比较,差异无统计学意义[(4.549±1.167)d,(4.580±0.889)d,t=-0.205,P=0.838]; 术前及术后1个月2组患者的疼痛VAS评分、Cobb's角比较,组间差异均无统计学意义[(7.524±0.946)分,(7.441±1.272)分,t=0.487,P=0.627;(0.829±0.379)分,(0.817±0.388)分,t=0.207,P=0.836; 20.195°±3.802°,19.828°±3.479°,t=0.667,P=0.506; 5.354°±1.828°,4.882°±1.276°,t=1.995,P=0.053],且术后1个月时2组患者的疼痛VAS评分和Cobb's角均较术前减小(t=62.030,P=0.000; t=49.081,P=0.000; t=33.665,P=0.000; t=40.132,P=0.000)。至术后12个月时联合治疗组发生邻近椎体骨折8例,PKP组发生邻近椎体骨折11例,2组患者的邻近椎体骨折发生率比较,差异无统计学意义(χ2=0.193,P=0.660); 联合治疗组19椎发生骨水泥渗漏,PKP组16椎发生骨水泥渗漏,2组患者的骨水泥渗漏发生率比较,差异无统计学意义(χ2=0.934,P=0.334)。结论:体位复位结合PVP手术与单纯PKP手术均可有效缓解骨质疏松性椎体压缩骨折患者的疼痛症状、恢复伤椎形态,二者的疗效及安全性相当,但前者具有手术时间短、术中透视次数少及治疗费用低的优势。
Abstract:
Objective:To compare the clinical curative effect and safety between postural reduction combined with percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures.Methods:One hundred and seventy-five patients with osteoporotic vertebral compression fractures were recruited from January 2009 to January 2014.Eighty-two patients(combination treatment group)were treated with postural reduction combined with PVP,while the others(PKP group)were treated with PKP.The operative time,intraoperative X-ray exposure,hospital stay,cost of treatment,pain visual analogue scale(VAS)scores,Cobb's angle and incidence rate of adjacent vertebral fractures and bone cement leakage were compared between the 2 groups.Results:The operative time,intraoperative X-ray exposure and cost of treatment were less in combination treatment group compared to PKP group(30.134+/-7.503 vs 55.215+/-12.781 min,t=-16.046,P=0.000; 15.610+/-1.322 vs 20.366+/-3.653 times,t=-11.716,P=0.000; 15 078.146+/-1 149.556 vs 31 659.765+/-1 662.886 RMB,t=-77.440,P=0.000).There was no statistical difference in hospital stay between the 2 groups(4.549+/-1.167 vs 4.580+/-0.889 days,t=-0.205,P=0.838).There was no statistical difference in pain VAS scores and Cobb's angle between the 2 groups before surgery and at 1 month after the surgery(7.524+/-0.946 vs 7.441+/-1.272 points,t=0.487,P=0.627; 0.829+/-0.379 vs 0.817+/-0.388 points,t=0.207,P=0.836; 20.195+/-3.802 vs 19.828+/-3.479 degrees,t=0.667,P=0.506; 5.354+/-1.828 vs 4.882+/-1.276 degrees,t=1.995,P=0.053).The pain VAS scores and Cobb's angle decreased in both of the 2 groups at 1 month after the surgery compared to pre-surgery(t=62.030,P=0.000; t=49.081,P=0.000; t=33.665,P=0.000; t=40.132,P=0.000).The adjacent vertebral fractures were found in combination treatment group(8)and PKP group(11)at 12 month after the surgery,and there was no statistical difference in the incidence rate of adjacent vertebral fractures between the 2 groups(χ2=0.193,P=0.660).The bone cement leakage were found in combination treatment group(19)and PKP group(16),and there was no statistical difference in the incidence rate of bone cement leakage between the 2 groups(χ2=0.934,P=0.334).Conclusion:Both combination thearpy of postural reduction and PVP and monotherapy of PKP can effectively relieve the pain and restore the morphous of injured vertebrae in the treatment of osteoporotic vertebral compression fractures.They are similar to each other in curative effect and safety,however,the former has such advantages as shorter operative time,less intraoperative X-ray exposure and lower cost of treatment.

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备注/Memo

备注/Memo:
2016-04-18收稿 2016-05-26修回
徐无忌 E-mail:xuwuji1@126.com

更新日期/Last Update: 1900-01-01