CAJ | 학술논문

目的：探讨改良小剂量骨水泥椎体成形术(PVP)方法治疗中老年胸腰椎病理性骨折的临床效果及安全性。方法选择2012年10月~2013年10月在沧州中西医结合医院住院治疗中老年胸腰椎病理性骨折患者300例,随机分为两组。治疗组150例,采用改良小剂量骨水泥PVP方法；对照组150例,采用传统PVP手术方法。观察两组患者治疗前后疼痛视觉类比评分(VAS)、术中骨水泥使用量、手术时间、器械花费等情况。结果两组患者PVP技术操作成功率均为100%。治疗组每节椎体平均手术时间为(22.23±3.57)min,对照组为(41.25±4.32)min,两组比较差异有统计学意义(P<0.05)；治疗组每节椎体注入骨水泥(2.45±0.32)mL,对照组为(4.17±0.57)mL,两组比较差异有统计学意义(P<0.05)；术后第3天,治疗组VAS评分为(2.47±0.51)分,对照组为(2.51±0.48)分,两组比较差异无统计学意义(P>0.05)。结论改良小剂量骨水泥PVP治疗方案不仅可以有效缓解患者临床症状,减少PVP相关并发症的发生,同时缩短了手术操作时间,简化了手术操作步骤,节约治疗费用,是治疗中老年胸腰椎病理性骨折安全、有效、可行、值得推广的方法。
목적：탐토개량소제량골수니추체성형술(PVP)방법치료중노년흉요추병이성골절적림상효과급안전성。방법선택2012년10월~2013년10월재창주중서의결합의원주원치료중노년흉요추병이성골절환자300례,수궤분위량조。치료조150례,채용개량소제량골수니PVP방법；대조조150례,채용전통PVP수술방법。관찰량조환자치료전후동통시각류비평분(VAS)、술중골수니사용량、수술시간、기계화비등정황。결과량조환자PVP기술조작성공솔균위100%。치료조매절추체평균수술시간위(22.23±3.57)min,대조조위(41.25±4.32)min,량조비교차이유통계학의의(P<0.05)；치료조매절추체주입골수니(2.45±0.32)mL,대조조위(4.17±0.57)mL,량조비교차이유통계학의의(P<0.05)；술후제3천,치료조VAS평분위(2.47±0.51)분,대조조위(2.51±0.48)분,량조비교차이무통계학의의(P>0.05)。결론개량소제량골수니PVP치료방안불부가이유효완해환자림상증상,감소PVP상관병발증적발생,동시축단료수술조작시간,간화료수술조작보취,절약치료비용,시치료중노년흉요추병이성골절안전、유효、가행、치득추엄적방법。
Objective To investigate the clinical efficacy, and safety of modified method of small dose of bone cement percutaneous vertebroplasty treated pathological fracture of thoracolumbar among middle-aged and elderly. Methods From October 2012 to October 2013, in Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, 300 patients with thoracolumbar pathological fracture were randomly divided into two groups. Treatment group (150 cases) was given the improved small doses of bone cement PVP method; the control group (150 cases) was given traditional PVP operation method. The pain visual analog scale (VAS) before and after treatment and bone cement usage, operation time, equipment cost of two groups were observed and compared. Results PVP technical operation suc-cess rate of two groups was 100%. Treatment group each vertebral body average operation time was (22.23±3.57) min, the control group was (41.25±4.32) min, the difference was statistically significant (P< 0.05); injected bone cement of each section in treatment group was (2.45±0.32) mL, the control group was (4.17±0.57) mL, the difference was statisti-cally significant (P< 0.05). After operation 3 days, VAS score of the treatment group was (2.47±0.51) scores, the con-trol group was (2.51±0.48) scores, the difference was not statistically significant (P > 0.05). Conclusion Modified method of small dose of bone cement PVP technology not only can effectively relieve the clinical symptoms, reduce the PVP related complications, but also can shorten the operation time, simplify the operation steps, save the cost of treat-ment. It is a method of safe, effective, feasible and worth extending in the treatment of thoracolumbar pathological frac-ture among middle-aged and elderly people.