中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
11期
9-11
,共3页
骨质疏松性骨折%椎体成形术
骨質疏鬆性骨摺%椎體成形術
골질소송성골절%추체성형술
Osteoporotic fractures%Vertebroplasty
目的 探讨骨质疏松性骨折椎体成形术后再骨折的治疗方法.方法 选取2010年1月至2011年1月收治的骨质疏松性骨折患者120例(140个椎体),将术后12个月内再次骨折的15例(20个椎体)患者作为研究对象,其中11例给予骨水泥强化治疗,术后抗感染,恢复期给予积极的康复锻炼指导;4例给予抗骨质疏松治疗.随访10个月,观察有无骨水泥外漏及抗骨质疏松的治疗恢复情况.结果 11例再次骨折的患者在注射骨水泥过程中均无椎前静脉渗漏及椎间盘渗漏,术后所有患者均未出现骨水泥渗漏,其中3例注射后出现背部疼痛,主要考虑为手术影响到局部神经功能,给予镇痛药治疗后疼痛明显减轻;4例抗骨质疏松治疗恢复可,无疼痛和不适症状发生.术后3d所有患者均可下床活动,均于术后1周内出院.所有患者均未出现充填剂不良性宿主反应,无再次骨折发生.通过疼痛视觉模拟量表(VAS)进行评分,治疗后3d和终末期随访时VAS评分均明显低于治疗前[(3.05±0.55),(0.05±0.15)分比(6.95±0.65)分],且终末期随访时VAS评分低于治疗后3d,差异均有统计学意义(P＜0.05).结论 骨水泥强化治疗辅以抗感染及康复锻炼指导及抗骨质疏松治疗对骨质疏松性骨折椎体成形术后再骨折的临床疗效确切,安全可靠,值得临床推广应用.
目的 探討骨質疏鬆性骨摺椎體成形術後再骨摺的治療方法.方法 選取2010年1月至2011年1月收治的骨質疏鬆性骨摺患者120例(140箇椎體),將術後12箇月內再次骨摺的15例(20箇椎體)患者作為研究對象,其中11例給予骨水泥彊化治療,術後抗感染,恢複期給予積極的康複鍛煉指導;4例給予抗骨質疏鬆治療.隨訪10箇月,觀察有無骨水泥外漏及抗骨質疏鬆的治療恢複情況.結果 11例再次骨摺的患者在註射骨水泥過程中均無椎前靜脈滲漏及椎間盤滲漏,術後所有患者均未齣現骨水泥滲漏,其中3例註射後齣現揹部疼痛,主要攷慮為手術影響到跼部神經功能,給予鎮痛藥治療後疼痛明顯減輕;4例抗骨質疏鬆治療恢複可,無疼痛和不適癥狀髮生.術後3d所有患者均可下床活動,均于術後1週內齣院.所有患者均未齣現充填劑不良性宿主反應,無再次骨摺髮生.通過疼痛視覺模擬量錶(VAS)進行評分,治療後3d和終末期隨訪時VAS評分均明顯低于治療前[(3.05±0.55),(0.05±0.15)分比(6.95±0.65)分],且終末期隨訪時VAS評分低于治療後3d,差異均有統計學意義(P＜0.05).結論 骨水泥彊化治療輔以抗感染及康複鍛煉指導及抗骨質疏鬆治療對骨質疏鬆性骨摺椎體成形術後再骨摺的臨床療效確切,安全可靠,值得臨床推廣應用.
목적 탐토골질소송성골절추체성형술후재골절적치료방법.방법 선취2010년1월지2011년1월수치적골질소송성골절환자120례(140개추체),장술후12개월내재차골절적15례(20개추체)환자작위연구대상,기중11례급여골수니강화치료,술후항감염,회복기급여적겁적강복단련지도;4례급여항골질소송치료.수방10개월,관찰유무골수니외루급항골질소송적치료회복정황.결과 11례재차골절적환자재주사골수니과정중균무추전정맥삼루급추간반삼루,술후소유환자균미출현골수니삼루,기중3례주사후출현배부동통,주요고필위수술영향도국부신경공능,급여진통약치료후동통명현감경;4례항골질소송치료회복가,무동통화불괄증상발생.술후3d소유환자균가하상활동,균우술후1주내출원.소유환자균미출현충전제불량성숙주반응,무재차골절발생.통과동통시각모의량표(VAS)진행평분,치료후3d화종말기수방시VAS평분균명현저우치료전[(3.05±0.55),(0.05±0.15)분비(6.95±0.65)분],차종말기수방시VAS평분저우치료후3d,차이균유통계학의의(P＜0.05).결론 골수니강화치료보이항감염급강복단련지도급항골질소송치료대골질소송성골절추체성형술후재골절적림상료효학절,안전가고,치득림상추엄응용.
Objective To investigate the treatment method of osteoporotic refracture after vertebroplasty.Methods One hundred and twenty patients (140 vertebraes) with osteoporotic fractures from January 2010 to January 2011 were selected,12 months after operation,15 cases of refracture (20vertebraes) patients as the research object,11 cases were given bone cement to strengthen treatment,postoperative anti-infection,recovery given a positive rehabilitation exercise instruction ;4 cases were given anti-osteoporosis treatment.Follow-up of 10 months,whether leakage of bone cement and the recovery of anti-osteoporosis treatment were observed.Results Eleven patients with refracture in the process of bone cement injection had no prevertebral venous leakage and disc leakage,none of the patients had bone cement leakage after operation;including 3 cases occurred back pain after injection,the main consideration was surgery influenced the local nerve functions and given analgesic treatment,then pain significantly reduced; 4cases with anti-osteoporosis therapy and recoverd better,no pain and other unsuitable symptom occurred.Postoperative 3 d all of the patients could get out of bed,were discharged on 1 week after operation.All patients were not appear the adverse host reaction of fillers,with no occurrence of refracture.Through visual analog pain scale(VAS) score,VAS score in the 3 d after treatment and end-stage follow-up were significantly lower than before treatment [(3.05 ± 0.55),(0.05 ± 0.15) scores vs.(6.95 ± 0.65) scores],and VAS score at the time of end-stage follow-up was lower than 3 d after treatment,there was significant difference (P ＜0.05).Conclusion Bone cement to strengthen with anti-infection and rehabilitation exercise instruction and anti-osteoporosis in the treatment of osteoporotic refracture after vertebroplasty curative effect,safe and reliable effect,worthy of clinical popularization and application.
