中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
3期
380-382
,共3页
骨质疏松%脊柱骨折%经皮球囊扩张椎体成形术
骨質疏鬆%脊柱骨摺%經皮毬囊擴張椎體成形術
골질소송%척주골절%경피구낭확장추체성형술
Osteoporosis%Spinal fractures%Percutaneous kyphoplasty
目的 探讨经皮球囊扩张椎体成形术(PKP)治疗骨质疏松性椎体隐匿性骨折的临床应用价值.方法 骨质疏松性椎体隐匿性骨折患者35例共52椎,按治疗方法不同分为两组,观察组共19例30椎用PKP治疗,对照组共16例22椎用保守治疗.术后疼痛缓解程度应用视觉模拟评分法进行评估分级,用日常生活自理能力(ADL)量表对治疗后患者生活质量进行评估,同时观察术后伤椎椎体形态学变化,分别在术后1周及3、6、12个月进行评价.结果 52节椎体穿刺全部成功,无椎管内渗漏和肺栓塞等并发症；治疗后1周及3、6个月各期疼痛缓解率观察组(分别为83.5％、89.7％、95.2％)明显优于对照组(分别为52.6％、65.4％、74.9％)(x2=7.12、6.24、5.92,均P＜0.01),12个月时疼痛缓解率两组分别为96.4％、89.5％,差异无统计学意义(x2 =3.05,P＞0.05)；治疗后1周及3、6个月各期生活质量评分观察组均明显优于对照组(均P＜0.01),12个月时生活质量评分两组差异无统计学意义(P＞0.05)；治疗后1周及3、6个月各期随访椎体前缘、中央、后缘高度两组差异均无统计学意义(均P ＞0.05)；12个月时对照组椎体塌陷较观察组明显[分别为(13.2±0.5)、(5.6±0.7)mm](t=3.03,P＜0.05).结论 PKP治疗骨质疏松性椎体隐匿性骨折与传统保守治疗相比,可迅速缓解疼痛,明显改善患者的生活质量；并可显著预防椎体进一步塌陷,防止脊椎后凸畸形发生.
目的 探討經皮毬囊擴張椎體成形術(PKP)治療骨質疏鬆性椎體隱匿性骨摺的臨床應用價值.方法 骨質疏鬆性椎體隱匿性骨摺患者35例共52椎,按治療方法不同分為兩組,觀察組共19例30椎用PKP治療,對照組共16例22椎用保守治療.術後疼痛緩解程度應用視覺模擬評分法進行評估分級,用日常生活自理能力(ADL)量錶對治療後患者生活質量進行評估,同時觀察術後傷椎椎體形態學變化,分彆在術後1週及3、6、12箇月進行評價.結果 52節椎體穿刺全部成功,無椎管內滲漏和肺栓塞等併髮癥；治療後1週及3、6箇月各期疼痛緩解率觀察組(分彆為83.5％、89.7％、95.2％)明顯優于對照組(分彆為52.6％、65.4％、74.9％)(x2=7.12、6.24、5.92,均P＜0.01),12箇月時疼痛緩解率兩組分彆為96.4％、89.5％,差異無統計學意義(x2 =3.05,P＞0.05)；治療後1週及3、6箇月各期生活質量評分觀察組均明顯優于對照組(均P＜0.01),12箇月時生活質量評分兩組差異無統計學意義(P＞0.05)；治療後1週及3、6箇月各期隨訪椎體前緣、中央、後緣高度兩組差異均無統計學意義(均P ＞0.05)；12箇月時對照組椎體塌陷較觀察組明顯[分彆為(13.2±0.5)、(5.6±0.7)mm](t=3.03,P＜0.05).結論 PKP治療骨質疏鬆性椎體隱匿性骨摺與傳統保守治療相比,可迅速緩解疼痛,明顯改善患者的生活質量；併可顯著預防椎體進一步塌陷,防止脊椎後凸畸形髮生.
목적 탐토경피구낭확장추체성형술(PKP)치료골질소송성추체은닉성골절적림상응용개치.방법 골질소송성추체은닉성골절환자35례공52추,안치료방법불동분위량조,관찰조공19례30추용PKP치료,대조조공16례22추용보수치료.술후동통완해정도응용시각모의평분법진행평고분급,용일상생활자리능력(ADL)량표대치료후환자생활질량진행평고,동시관찰술후상추추체형태학변화,분별재술후1주급3、6、12개월진행평개.결과 52절추체천자전부성공,무추관내삼루화폐전새등병발증；치료후1주급3、6개월각기동통완해솔관찰조(분별위83.5％、89.7％、95.2％)명현우우대조조(분별위52.6％、65.4％、74.9％)(x2=7.12、6.24、5.92,균P＜0.01),12개월시동통완해솔량조분별위96.4％、89.5％,차이무통계학의의(x2 =3.05,P＞0.05)；치료후1주급3、6개월각기생활질량평분관찰조균명현우우대조조(균P＜0.01),12개월시생활질량평분량조차이무통계학의의(P＞0.05)；치료후1주급3、6개월각기수방추체전연、중앙、후연고도량조차이균무통계학의의(균P ＞0.05)；12개월시대조조추체탑함교관찰조명현[분별위(13.2±0.5)、(5.6±0.7)mm](t=3.03,P＜0.05).결론 PKP치료골질소송성추체은닉성골절여전통보수치료상비,가신속완해동통,명현개선환자적생활질량；병가현저예방추체진일보탑함,방지척추후철기형발생.
Objective To study the results of percutaneous kyphoplasty(PKP) in treating subtle fracture of osteoporotic vertebral body,and to explore the clinical value of PKP in patients with subtle fracture of osteoporotic vertebral body.Methods 52 thoracical vertebral bodies of 35 patients with subtle fracture of osteoporotic vertebral body.Nineteen patients with 30 vertebrae were assigned to group 1 treated by PKP,and sixteen patients with 22 vertebrae were assigned to group 2 treated by conservative therapy.The patients were examined after surgery to ascertain the alleviation of the pain and evaluate the patients' life quality,measuring the heights of vertebrae on the lateral plain films during follow-up.Results Surgery was successful in all cases,no serious complications occurred with PVP.Pain relief was obtained in all of group 1,pain still remained in all 16 patients of group 2 at 1 week after conservative treatment.Improvement was significantly greater in the group 1 than in group 2 at1 week,1 month,3 months,6 months,but no difference at 12 months after treatment (P ＞ 0.05 ).According to ADL,the patients' life quality scores,improvement was significantly greater in the group 1 than in group 2 at1 week,1 month,3 months,6 months,but no difference at 12 months after treatment(P ＞ 0.05 ).The height of the veterbral body showed significant difference at 12 months of follow( P ＜ 0.05).Conclusion PKP was an effective and safe procedure for treating subtle fracture of osteoporotic vertebral body.PKP has satisfactory analgesic effect on subtle fracture of osteoporotic vertebral body and improve quality of patients' life.PKP could effectively prevent collapse of veterbral body.
