CAJ | 학술논문

背景：通过经皮穿刺向椎体内注射骨水泥可增强椎体强度及稳定椎体，达到止痛目的，但骨水泥可能在注入过程中渗漏入椎旁血管，并通过腔静脉系统回流至右心室进而进入肺动脉造成肺栓塞。 　　目的：探讨经皮椎体成形中骨水泥椎旁血管渗漏与骨水泥性肺栓塞的关系。 　　方法：回顾性分析骨质疏松性椎体压缩骨折行椎体成形患者134例，其中出现骨水泥椎旁血管渗漏患者共23例设为实验组，取未出现骨水泥椎旁血管渗漏且有完整影像学资料43例患者设为对照组。通过椎体成形前后行脊柱和胸部X射线检查确定两组患者是否存在骨水泥椎旁血管渗漏及骨水泥性肺栓塞。 　　结果与结论：134例患者中共有23例出现骨水泥椎旁血管渗漏，占17.2%。出现椎旁血管渗漏的23例中有3例出现骨水泥性肺栓塞，占出现椎旁血管渗漏患者的13%，但均无胸部症状。对照组43例患者中未出现椎旁血管渗漏的患者也未出现骨水泥性肺栓塞，两组比较差异有显著性意义(P=0.039)。提示骨质疏松性椎体压缩骨折患者行椎体成形过程中一旦出现骨水泥椎旁血管渗漏，尽管并无胸部症状仍应警惕骨水泥性肺栓塞可能。
배경：통과경피천자향추체내주사골수니가증강추체강도급은정추체，체도지통목적，단골수니가능재주입과정중삼루입추방혈관，병통과강정맥계통회류지우심실진이진입폐동맥조성폐전새。 　　목적：탐토경피추체성형중골수니추방혈관삼루여골수니성폐전새적관계。 　　방법：회고성분석골질소송성추체압축골절행추체성형환자134례，기중출현골수니추방혈관삼루환자공23례설위실험조，취미출현골수니추방혈관삼루차유완정영상학자료43례환자설위대조조。통과추체성형전후행척주화흉부X사선검사학정량조환자시부존재골수니추방혈관삼루급골수니성폐전새。 　　결과여결론：134례환자중공유23례출현골수니추방혈관삼루，점17.2%。출현추방혈관삼루적23례중유3례출현골수니성폐전새，점출현추방혈관삼루환자적13%，단균무흉부증상。대조조43례환자중미출현추방혈관삼루적환자야미출현골수니성폐전새，량조비교차이유현저성의의(P=0.039)。제시골질소송성추체압축골절환자행추체성형과정중일단출현골수니추방혈관삼루，진관병무흉부증상잉응경척골수니성폐전새가능。
BACKGROUND:Percutaneous injection of bone cement into the vertebral body can enhance the vertebral strength and vertebral stability, and obtain pain relief. But the bone cement may leakage into the paravertebral vessels during injection, and may back to the right ventricle and flow into the pulmonary artery through vena cave and thus causing pulmonary embolism. OBJECTIVE:To evaluate the relationship between cement paravertebral vascular leakage and pulmonary cement embolism during percutaneous vertebroplasty. METHODS:Total y 134 cases of osteoporotic compression fractures treated with vertebroplasty were retrospectively analyzed. Among them, 23 cases of cement paravertebral vascular leakage were considered as the experimental group, and the 43 cases without cement paravertebral vascular leakage and had the complete imaging data were considered as the control group. The spine and chest X-ray films were taken before and after vertebroplasty to detect whether there were cement paravertebral vascular leakage and pulmonary cement embolism in the patients of two groups. RESULTS AND CONCLUSION:Among the 134 patients, 23 patients had cement paravertebral vascular leakage, and accounted for 17.2%. Among the 23 patients with cement paravertebral vascular leakage, three cases had pulmonary cement embolism without chest symptoms, and accounted for 13%. No pulmonary cement embolism occurred in the 43 patients without paravertebral vascular leakage of the control group, and there was no significant difference between two groups (P=0.039). Although the patients with cement pulmonary embolism remained asymptomatic, pulmonary cement embolism remained possible if cement paravertebral vascular leakage was detected during vertebroplasty.