CAJ | 학술논문

目的：探讨经皮椎体后凸成形术(PKP﹚在骨质疏松性椎体压缩骨折中的应用。方法选取2011年1月~2013年12月我院骨科行手术治疗的骨质疏松性椎体压缩骨折患者68例。采用随机数字表将选取的68例患者分为PKP组(n=34﹚和PVP组(n=34﹚,分别采用PKP和PVP方法进行手术治疗。观察两组患者的手术时间、骨水泥注入量、骨水泥渗漏和疼痛缓解情况,随访术后1个月椎体压缩率和Cobb's角恢复情况。结果 PVP组患者的单个椎体手术时间和骨水泥注入量明显少于PKP组(P<0.05﹚。PVP组发生骨水泥渗漏14例(41.18%﹚,PKP组发生骨水泥渗漏6例(17.65%﹚,PVP组骨水泥渗漏发生率明显高于PKP组(χ2=4.53,P<0.05﹚。术后1周,两组患者VAS疼痛评分均较术前明显下降(P<0.01﹚,两组患者VAS疼痛评分下降值比较差异无统计学意义(P>0.05﹚。术后1月,两组患者椎体压缩率和Cobb's角均较术前改善(P<0.05或P<0.01﹚,且PKP组改善率明显优于PVP组(P<0.05﹚。结论 PVP和 PKP治疗骨质疏松性椎体压缩骨折的止痛效果均较好,均能有效地缓解患者的疼痛症状,PKP能更好地恢复椎体高度,减少骨水泥渗漏的发生率。
목적：탐토경피추체후철성형술(PKP﹚재골질소송성추체압축골절중적응용。방법선취2011년1월~2013년12월아원골과행수술치료적골질소송성추체압축골절환자68례。채용수궤수자표장선취적68례환자분위PKP조(n=34﹚화PVP조(n=34﹚,분별채용PKP화PVP방법진행수술치료。관찰량조환자적수술시간、골수니주입량、골수니삼루화동통완해정황,수방술후1개월추체압축솔화Cobb's각회복정황。결과 PVP조환자적단개추체수술시간화골수니주입량명현소우PKP조(P<0.05﹚。PVP조발생골수니삼루14례(41.18%﹚,PKP조발생골수니삼루6례(17.65%﹚,PVP조골수니삼루발생솔명현고우PKP조(χ2=4.53,P<0.05﹚。술후1주,량조환자VAS동통평분균교술전명현하강(P<0.01﹚,량조환자VAS동통평분하강치비교차이무통계학의의(P>0.05﹚。술후1월,량조환자추체압축솔화Cobb's각균교술전개선(P<0.05혹P<0.01﹚,차PKP조개선솔명현우우PVP조(P<0.05﹚。결론 PVP화 PKP치료골질소송성추체압축골절적지통효과균교호,균능유효지완해환자적동통증상,PKP능경호지회복추체고도,감소골수니삼루적발생솔。
Objective To discuss the application of PKP in osteoporotic vertebral compression fractures. Methods A total of 68 cases of patients with osteoporotic vertebral compression fractures were given the operative medical treat-ment in our hospital’s department of orthopedics during the period from January 2011 to December 2013, they were selected and divided into PKP group(n=34) and PVP group(n=34) by table of random number, and given PKP and PVP operation respectively. The operation time, bone cement injection volume, leakage and easement of pain of patients in two groups were observed and compared, and the recovery of vertebral compression rate and Cobb's angle was followed up one month after the operation as well. Results Each centrum operation time and bone cement injection volume of patients in PVP group were obviously lower or less than those in PKP group (P<0.05). 14 and 6 cases of bone cement leakage appeared in PVP group (41.18%) and PKP group (17.65%) respectively, and the occurrence rate of bone cement leakage of patients in PVP group was much higher than that in PKP group (χ2=4.53, P<0.05). One week after the opera-tion, the VAS scores of patients in two groups obviously declined than before(P<0.01), and compared the declining rates of VAS scores of patients in two groups, there were no obvious differences appeared (P>0.05). The vertebral compression rate and Cobb's angle of patients in two groups were obviously improved than before (P<0.05 or P<0.01), and the improve ment rate in PKP group was much better than that in PVP group (P<0.05). Conclusion PVP and PKP have favorable cu-rative effect on analgesic effect of osteoporotic vertebral compression fractures, which can effectively relieve the pain symptoms, while PKP can recover the vertebral height better, reduce the occurrence rate of bone cement leakage with higher security.