中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
27期
17-21
,共5页
黄圣升%詹新立%吴华%瞿岱彪%欧阳宇轩%杨景瑞
黃聖升%詹新立%吳華%瞿岱彪%歐暘宇軒%楊景瑞
황골승%첨신립%오화%구대표%구양우헌%양경서
椎体压缩性骨折%单侧分次椎体后凸成形%治疗效果
椎體壓縮性骨摺%單側分次椎體後凸成形%治療效果
추체압축성골절%단측분차추체후철성형%치료효과
Vertebral compression fractures%Unilateral and fractionated percutaneous kyphoplasty%Treatment effect
目的：探讨单侧分次法椎体成形术对急性老年性椎体压缩性骨折的治疗效果。方法：选取2010年11月-2012年5月本院收治的46例（共82椎）急性椎体压缩性骨折的老年患者，所有患者均给予单侧椎体成形治疗，即利用球囊式椎体扩张器，采取单侧分次经皮穿刺的方法，对病椎进行扩张，并于扩张后行骨水泥填充；观察比较手术前后患者的疼痛视觉模拟评分（VAS）及下腰痛（JOA）评分水平，并比较病锥的前、后缘及中央高度的变化。结果：46例患者的椎体手术均顺利结束，所有患者均未表现出严重并发症。所有患者术后3 d的VAS评分（3.21±0.36）分与术后6个月的（3.78±0.83）分均明显低于术前的（6.83±0.34）分，术后3 d的下腰痛JOA评分（21.58±0.39）分与术后6个月的（20.64±0.95）分均明显高于术前的（16.13±0.46）分，且术后3 d和术后6个月的病椎的前、后缘及中央高度均明显高于术前，差异均有统计学意义（P<0.05），而术后3 d与术后6个月上述各观察指标均无统计学意义（P>0.05）。术后“靶椎”高度再丢失不明显。结论：应用单侧分次椎体成形术治疗急性期老年性椎体压缩性骨折能有效缓解疼痛，提高骨水泥弥散程度及减少椎管内骨水泥渗漏，值得临床推广。
目的：探討單側分次法椎體成形術對急性老年性椎體壓縮性骨摺的治療效果。方法：選取2010年11月-2012年5月本院收治的46例（共82椎）急性椎體壓縮性骨摺的老年患者，所有患者均給予單側椎體成形治療，即利用毬囊式椎體擴張器，採取單側分次經皮穿刺的方法，對病椎進行擴張，併于擴張後行骨水泥填充；觀察比較手術前後患者的疼痛視覺模擬評分（VAS）及下腰痛（JOA）評分水平，併比較病錐的前、後緣及中央高度的變化。結果：46例患者的椎體手術均順利結束，所有患者均未錶現齣嚴重併髮癥。所有患者術後3 d的VAS評分（3.21±0.36）分與術後6箇月的（3.78±0.83）分均明顯低于術前的（6.83±0.34）分，術後3 d的下腰痛JOA評分（21.58±0.39）分與術後6箇月的（20.64±0.95）分均明顯高于術前的（16.13±0.46）分，且術後3 d和術後6箇月的病椎的前、後緣及中央高度均明顯高于術前，差異均有統計學意義（P<0.05），而術後3 d與術後6箇月上述各觀察指標均無統計學意義（P>0.05）。術後“靶椎”高度再丟失不明顯。結論：應用單側分次椎體成形術治療急性期老年性椎體壓縮性骨摺能有效緩解疼痛，提高骨水泥瀰散程度及減少椎管內骨水泥滲漏，值得臨床推廣。
목적：탐토단측분차법추체성형술대급성노년성추체압축성골절적치료효과。방법：선취2010년11월-2012년5월본원수치적46례（공82추）급성추체압축성골절적노년환자，소유환자균급여단측추체성형치료，즉이용구낭식추체확장기，채취단측분차경피천자적방법，대병추진행확장，병우확장후행골수니전충；관찰비교수술전후환자적동통시각모의평분（VAS）급하요통（JOA）평분수평，병비교병추적전、후연급중앙고도적변화。결과：46례환자적추체수술균순리결속，소유환자균미표현출엄중병발증。소유환자술후3 d적VAS평분（3.21±0.36）분여술후6개월적（3.78±0.83）분균명현저우술전적（6.83±0.34）분，술후3 d적하요통JOA평분（21.58±0.39）분여술후6개월적（20.64±0.95）분균명현고우술전적（16.13±0.46）분，차술후3 d화술후6개월적병추적전、후연급중앙고도균명현고우술전，차이균유통계학의의（P<0.05），이술후3 d여술후6개월상술각관찰지표균무통계학의의（P>0.05）。술후“파추”고도재주실불명현。결론：응용단측분차추체성형술치료급성기노년성추체압축성골절능유효완해동통，제고골수니미산정도급감소추관내골수니삼루，치득림상추엄。
Objective:To investigate the treatment effect of unilateral and fractionated percutaneous kyphoplasty in treatment of acute senile vertebral compression fractures.Method:46 elderly patients(a total of 82 vertebral)with acute vertebral compression fractures in our hospital from November 2010 to May 2012 were selected,all patients were given unilateral vertebral plasty,the balloon expander vertebral dilator was used and unilateral points of percutaneous puncture method was taken,the disease of vertebral were expanded,and then filled with bone cement.The visual analogue scale (VAS)and low back pain score(JOA),front,rear and central height change of the disease cone before and after surgery in patients were observed and compared.Result:46 patients with vertebral surgery ended smoothly,all patients showed no severe complications.The VAS average score after surgery 3 days was(3.21±0.36)score and the 6 month postoperatively was(3.78±0.83)score,they were significantly lower than(6.83±0.34)score preoperatively,and the lumbago JOA average score after surgery 3 days was(21.58±0.39)score and the 6 month postoperatively was(20.64±0.95) score,they were significantly higher than(16.13±0.46)score preoperatively,and the front,rear and central height change of the disease cone after 3 days and the 6 months postoperatively were significantly higher than before surgery, the differences were statistically significant(P<0.05),while there were no significant differences in the observation of indexes between after 3 days and the 6 months postoperatively(P>0.05).Postoperative"target vertebral”height loss was not obvious.Conclusion:Application unilateral and fractionated percutaneous kyphoplasty in treatment of acute senile vertebral compression fractures can effectively relieve pain,increase bone cement dispersion degree and reduce spinal canal leakage of bone cement,is worthy of clinical promotion.
