中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2015年
4期
312-316
,共5页
郑毓嵩%张勇%林金丁%施建辉%王清铿
鄭毓嵩%張勇%林金丁%施建輝%王清鏗
정육숭%장용%림금정%시건휘%왕청갱
骨质疏松%脊柱骨折%椎体成形术%骨水泥渗漏
骨質疏鬆%脊柱骨摺%椎體成形術%骨水泥滲漏
골질소송%척주골절%추체성형술%골수니삼루
Osteoporosis%Spinal fractures%Vertebroplasty%Bone cement leakage
目的 探寻经皮椎体成形术(PVP)与经皮后凸成形术(PKP)治疗椎体骨质疏松性压缩性骨折出现骨水泥渗漏的相关危险因素.方法 回顾性分析2008年1月-2014年6月收治的PVP和PKP患者108例(114个椎体).根据是否出现骨水泥渗漏将患者分为骨水泥渗漏组(32例)和无骨水泥渗漏组(76例),对两组患者的性别、年龄、一次性治疗椎体的个数、伤椎解剖位置、术式选择(PKP或PVP)、椎体后壁的完整性、穿刺方式(单侧或双侧)、医师的技术水平、骨水泥注入量等资料进行统计分析.结果 术后共36个椎体(31.6％)出现骨水泥渗漏,78个椎体无骨水泥渗漏.性别、年龄、伤椎解剖位置、穿刺路径的选择、主刀医师的专业技术水平与骨水泥渗漏无相关性(P＞0.05);而一次性治疗椎体的个数、术式的选择、椎体的骨折情况、骨水泥注入量与骨水泥渗漏有相关性(P＜0.05).结论 椎体成形术后骨水泥渗漏与一次性治疗椎体的个数、术式的选择、椎体的骨折情况、骨水泥注入量有关.掌握正确的操作方法和适应证、注入适量的高黏度骨水泥量,可以减少骨水泥渗漏的发生.
目的 探尋經皮椎體成形術(PVP)與經皮後凸成形術(PKP)治療椎體骨質疏鬆性壓縮性骨摺齣現骨水泥滲漏的相關危險因素.方法 迴顧性分析2008年1月-2014年6月收治的PVP和PKP患者108例(114箇椎體).根據是否齣現骨水泥滲漏將患者分為骨水泥滲漏組(32例)和無骨水泥滲漏組(76例),對兩組患者的性彆、年齡、一次性治療椎體的箇數、傷椎解剖位置、術式選擇(PKP或PVP)、椎體後壁的完整性、穿刺方式(單側或雙側)、醫師的技術水平、骨水泥註入量等資料進行統計分析.結果 術後共36箇椎體(31.6％)齣現骨水泥滲漏,78箇椎體無骨水泥滲漏.性彆、年齡、傷椎解剖位置、穿刺路徑的選擇、主刀醫師的專業技術水平與骨水泥滲漏無相關性(P＞0.05);而一次性治療椎體的箇數、術式的選擇、椎體的骨摺情況、骨水泥註入量與骨水泥滲漏有相關性(P＜0.05).結論 椎體成形術後骨水泥滲漏與一次性治療椎體的箇數、術式的選擇、椎體的骨摺情況、骨水泥註入量有關.掌握正確的操作方法和適應證、註入適量的高黏度骨水泥量,可以減少骨水泥滲漏的髮生.
목적 탐심경피추체성형술(PVP)여경피후철성형술(PKP)치료추체골질소송성압축성골절출현골수니삼루적상관위험인소.방법 회고성분석2008년1월-2014년6월수치적PVP화PKP환자108례(114개추체).근거시부출현골수니삼루장환자분위골수니삼루조(32례)화무골수니삼루조(76례),대량조환자적성별、년령、일차성치료추체적개수、상추해부위치、술식선택(PKP혹PVP)、추체후벽적완정성、천자방식(단측혹쌍측)、의사적기술수평、골수니주입량등자료진행통계분석.결과 술후공36개추체(31.6％)출현골수니삼루,78개추체무골수니삼루.성별、년령、상추해부위치、천자로경적선택、주도의사적전업기술수평여골수니삼루무상관성(P＞0.05);이일차성치료추체적개수、술식적선택、추체적골절정황、골수니주입량여골수니삼루유상관성(P＜0.05).결론 추체성형술후골수니삼루여일차성치료추체적개수、술식적선택、추체적골절정황、골수니주입량유관.장악정학적조작방법화괄응증、주입괄량적고점도골수니량,가이감소골수니삼루적발생.
Objective To investigate the related risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) of osteoporotic vertebral compression fracture.Methods A retrospective study was made on 108 patients (114 vertebrae) undergone PVP and PKP between January 2008 and June 2014.There were 32 patients with cement leakage and 76 patients without cement leakage.Between-group differences were analyzed in terms of gender,age,number of one-time treated vertebrae,anatomic dissection,surgical procedures (PKP or PVP),integrity of the posterior vertebral wall,puncture approaches (unilateral or bilateral),technical level of surgeons and bone cement volume.Results Bone cement leakage occurred in 36 vertebrae (with the proportion of 31.6％).Cement leakage was associated with number of one-time treated vertebrae,surgical procedures,fractured condition,and bone cement volume (P ＜ 0.05),but not with gender,age,anatomical site of injury,puncture approaches,and technical level of surgeons (P ＞ 0.05).Conclusions Bone cement leakage after PKP or PVP correlated with number of vertebrae with one-time therapy,surgical procedures,fractured condition,and volume of bone cement.A good master of technical procedures and indications and suitable injection of high viscosity bone cement can help reduce the incidence of cement leakage.
