CAJ | 학술논문

目的：比较椎体后凸成形术（PKP）与椎体成形术（PVP）治疗骨质疏松性椎体压缩骨折的临床疗效。方法选取2009年2月至2013年5月重庆市东南医院收治的150例骨质疏松性椎体压缩骨折患者作为研究对象，采用随机数字表法将患者随机分为PVP组和 PKP组，各75例，分别采用PVP、PKP治疗，比较患者术前及术后1 d的疼痛情况，记录患者术前、术后1 d及术后1年的损伤椎体高度和后突角，比较两组患者随访1年中手术椎体损失的高度、术中水泥渗漏情况及术后邻近椎体骨折的发生情况。结果 PVP 组、PKP 组患者术后1 d 的疼痛视觉评分均较治疗前显著下降[（2.44±0.98）分比（7.81±2.32）分；（2.38±0.99）分比（7.72±2.21）分，P ＜0.01]。经过治疗后，PVP组患者术后1 d和术后1年的损伤椎体高度分别为（23.7±2.3） mm和（21.8±2.0） mm，后突角分别为（17.6±1.9）°和（18.0±1.9）°；PKP组患者术后1d和术后1年的损伤椎体高度分别为（27.5±2.6） mm和（26.6±2.1） mm，后突角分别为（11.8±1.1）°和（11.9±1.0）°，两组的损伤椎体高度均较治疗前显著增加（P＜0.05），后突角均较治疗前显著减小（P ＜0.05）；随访1年后，PVP组的损失椎体高度显著高于PKP组[（8.2±0.8）％比（4.1±0.5）％，P＜0.05]，PVP组患者水泥渗漏率显著高于PKP组[22.7％（17例）比10.7％（8例），P＜0.05]，术后两组患者邻近椎体骨折发生率差异无统计学意义（P＞0.05）。结论 PKP和 PVP在骨质疏松性椎体压缩性骨折的治疗中均有较好的临床疗效，PKP临床疗效优于PVP，且术中并发症发生率较低。
목적：비교추체후철성형술（PKP）여추체성형술（PVP）치료골질소송성추체압축골절적림상료효。방법선취2009년2월지2013년5월중경시동남의원수치적150례골질소송성추체압축골절환자작위연구대상，채용수궤수자표법장환자수궤분위PVP조화 PKP조，각75례，분별채용PVP、PKP치료，비교환자술전급술후1 d적동통정황，기록환자술전、술후1 d급술후1년적손상추체고도화후돌각，비교량조환자수방1년중수술추체손실적고도、술중수니삼루정황급술후린근추체골절적발생정황。결과 PVP 조、PKP 조환자술후1 d 적동통시각평분균교치료전현저하강[（2.44±0.98）분비（7.81±2.32）분；（2.38±0.99）분비（7.72±2.21）분，P ＜0.01]。경과치료후，PVP조환자술후1 d화술후1년적손상추체고도분별위（23.7±2.3） mm화（21.8±2.0） mm，후돌각분별위（17.6±1.9）°화（18.0±1.9）°；PKP조환자술후1d화술후1년적손상추체고도분별위（27.5±2.6） mm화（26.6±2.1） mm，후돌각분별위（11.8±1.1）°화（11.9±1.0）°，량조적손상추체고도균교치료전현저증가（P＜0.05），후돌각균교치료전현저감소（P ＜0.05）；수방1년후，PVP조적손실추체고도현저고우PKP조[（8.2±0.8）％비（4.1±0.5）％，P＜0.05]，PVP조환자수니삼루솔현저고우PKP조[22.7％（17례）비10.7％（8례），P＜0.05]，술후량조환자린근추체골절발생솔차이무통계학의의（P＞0.05）。결론 PKP화 PVP재골질소송성추체압축성골절적치료중균유교호적림상료효，PKP림상료효우우PVP，차술중병발증발생솔교저。
Objective To compare the clinical efficacy of percutaneous kyphoplasty ( PKP) and percuta-neous vertebroplasty ( PVP ) in the treatment of osteoporotic vertebral compression fractures ( OVCF ) . Methods From Feb.2009 to May 2013,150 cases of OVCF admitted to Chongqing Dongnan Hospital were included.They were divided into PVP group and PKP group by the random number table method.The pain before and 1 day after operation were compared,and the injury vertebral height and kyphosis angle of patients before surgery,1 day and 1 year after operation were recorded.Besides, the height of vertebral loss,leakage of bone cement,and the postoperative occurrences of adjacent vertebral fracture were also compared between the two groups during the one-year follow-up.Results Compared with pre-operation, visual analog scale ( VAS) scores of PVP group and PKP group one day after the treatment both decreased significantly ( P <0.01)[from(7.81 ±2.32) to (2.44 ±0.98), from(7.72 ±2.21) to (2.38 ±0.99)].One day and one year after the treatment, the injury vertebral heights of PVP group were (23.7 ±2.3) mm, (21.8 ±2.0) mm respectively, while the kyphotic angles were (17.6 ±1.9)°and(18.0 ±1.9)°.Correspondingly, that PKP of group were (27.5 ±2.6) mm and (26.6 ±2.1) mm,(11.8 ±1.1)°and (11.9 ±1.0)°.The injury vertebral heights of both groups increased significantly ( P <0 .05 ) , while the kyphotic angles decreased significantly(P<0.05).One year after surgery,the vertebral heights loss of PVP group were sig-nificantly higher than PKP group[(8.2 ±0.8)% vs (4.1 ±0.5)%,P <0.05].There were 17 cases (22.7%) in PVP group with cement leakage,8 cases (10.7%) in PKP group, which showed significant differences(P<0.05).There was no statistically significant difference in the incidence of adjacent vertebral fracture between the two groups after sugery(P>0.05).Conclusion Both PKP and PVP have great cura-tive effects in the treatment of OVCF.However the PKP has better clinical efficacy and less complications .