中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2015年
4期
289-293
,共5页
崔维%刘宝戈%王磊%亢卫波
崔維%劉寶戈%王磊%亢衛波
최유%류보과%왕뢰%항위파
骨折,压缩性%骨质疏松性骨折%经皮椎体后凸成形术%骨水泥%球囊
骨摺,壓縮性%骨質疏鬆性骨摺%經皮椎體後凸成形術%骨水泥%毬囊
골절,압축성%골질소송성골절%경피추체후철성형술%골수니%구낭
Fractures,compression%Osteoporotic fractures%Percutaneous kyphoplasty%Bone cement%Balloon
目的 探讨经皮椎体后凸成形术(PKP)术中数据在预测骨水泥注射量(CV)时的作用.方法 回顾性分析2012年1月至2013年12月因骨质疏松性压缩性骨折在首都医科大学附属北京天坛医院接受PKP治疗的93例患者共154个椎体的临床资料.所有椎体均使用双侧球囊扩张,透视下经工作通道双侧同时注入处于拉丝期的聚甲基丙烯酸甲酯骨水泥.记录球囊扩张体积(BV)、球囊峰值压力(Pmax)、CV,并计算Pmax与BV比值(P/BV),分析BV与CV的线性关系.结果 154个椎体中7个椎体出现渗漏,无骨水泥渗漏入椎管,无患者出现神经损伤.93例患者PKP术后3d腰部疼痛视觉模拟评分(VAS)为0～2分.无骨水泥渗漏的147个椎体的BV为2.1～6.3 ml,Pmax为130～ 359 psi,CV为2.8～8.5 ml,P/BV为25～263 psi/ml.所有患者的平均BV与CV无高度相关性(R＜0.75).依据P/BV值将145个椎体分为3组:P/BV＜ 100组、100≤P/BV＜ 200组、P/BV≥200组.3组椎体内BV与CV有高度相关性(R＞0.75,P＜0.01),且呈线性关系.P/BV＜ 100组CV为BV的0.9～1.1倍;100≤P/BV＜ 200组CV为BV的1.4～1.6倍;P/BV≥200组CV为BV的2.0～2.2倍.结论 通过BV和P/BV两个客观数据可以预测CV,以减少骨水泥渗漏的发生,防止CV不足导致的疗效不佳.
目的 探討經皮椎體後凸成形術(PKP)術中數據在預測骨水泥註射量(CV)時的作用.方法 迴顧性分析2012年1月至2013年12月因骨質疏鬆性壓縮性骨摺在首都醫科大學附屬北京天罈醫院接受PKP治療的93例患者共154箇椎體的臨床資料.所有椎體均使用雙側毬囊擴張,透視下經工作通道雙側同時註入處于拉絲期的聚甲基丙烯痠甲酯骨水泥.記錄毬囊擴張體積(BV)、毬囊峰值壓力(Pmax)、CV,併計算Pmax與BV比值(P/BV),分析BV與CV的線性關繫.結果 154箇椎體中7箇椎體齣現滲漏,無骨水泥滲漏入椎管,無患者齣現神經損傷.93例患者PKP術後3d腰部疼痛視覺模擬評分(VAS)為0～2分.無骨水泥滲漏的147箇椎體的BV為2.1～6.3 ml,Pmax為130～ 359 psi,CV為2.8～8.5 ml,P/BV為25～263 psi/ml.所有患者的平均BV與CV無高度相關性(R＜0.75).依據P/BV值將145箇椎體分為3組:P/BV＜ 100組、100≤P/BV＜ 200組、P/BV≥200組.3組椎體內BV與CV有高度相關性(R＞0.75,P＜0.01),且呈線性關繫.P/BV＜ 100組CV為BV的0.9～1.1倍;100≤P/BV＜ 200組CV為BV的1.4～1.6倍;P/BV≥200組CV為BV的2.0～2.2倍.結論 通過BV和P/BV兩箇客觀數據可以預測CV,以減少骨水泥滲漏的髮生,防止CV不足導緻的療效不佳.
목적 탐토경피추체후철성형술(PKP)술중수거재예측골수니주사량(CV)시적작용.방법 회고성분석2012년1월지2013년12월인골질소송성압축성골절재수도의과대학부속북경천단의원접수PKP치료적93례환자공154개추체적림상자료.소유추체균사용쌍측구낭확장,투시하경공작통도쌍측동시주입처우랍사기적취갑기병희산갑지골수니.기록구낭확장체적(BV)、구낭봉치압력(Pmax)、CV,병계산Pmax여BV비치(P/BV),분석BV여CV적선성관계.결과 154개추체중7개추체출현삼루,무골수니삼루입추관,무환자출현신경손상.93례환자PKP술후3d요부동통시각모의평분(VAS)위0～2분.무골수니삼루적147개추체적BV위2.1～6.3 ml,Pmax위130～ 359 psi,CV위2.8～8.5 ml,P/BV위25～263 psi/ml.소유환자적평균BV여CV무고도상관성(R＜0.75).의거P/BV치장145개추체분위3조:P/BV＜ 100조、100≤P/BV＜ 200조、P/BV≥200조.3조추체내BV여CV유고도상관성(R＞0.75,P＜0.01),차정선성관계.P/BV＜ 100조CV위BV적0.9～1.1배;100≤P/BV＜ 200조CV위BV적1.4～1.6배;P/BV≥200조CV위BV적2.0～2.2배.결론 통과BV화P/BV량개객관수거가이예측CV,이감소골수니삼루적발생,방지CV불족도치적료효불가.
Objective To analyze the percutaneous kyphoplasty (PKP) data statistically to predict the bone cement volume (CV).Methods Retrospective analysis of 93 patients with 154 vertebrae of osteoporotic vertebra compressed fracture,who received PKP from January 2012 to December 2013 in Beijing Tian Tan Hospital,Capital Medical University.All procedures were bilateral and non-high-pressure polymethyl methacrylate injection.The balloon volume (BV),balloon peak pressure (Pmax),CV and the ratio of Pmax to BV (P/BV) were documented.The data was analyzed by correlation analysis and linear regression analysis to reveal the correlation between BV and CV.Results Seven vertebrae had bone cement leakage,no intraspinal leakage,no neuro-deficit.Visual analogue scale was 0-2 of all patients on 3 d postoperation.The data of 147 vertebrae without leakage:BV was 2.1-6.3 ml,Pmax was 130-359 psi,CV was 2.8-8.5 ml,and the ratio of Pmax to BV (P/BV) was 25-263 psi/ml.The data analysis showed there was no high correlation between BV and CV as one group (R ＜ 0.75).However if divided the data into three groups by the value of P/BV,group A (P/BV ＜ 100),group B (100≤P/BV ＜200),group C (P/BV≥ 200),there was high correlation and linear relationship between BV and CV in each group (R ＞ 0.75,P ＜0.01).CV was 0.9-1.1 times of BV in group A;CV was 1.4-1.6 times of BV in group B; and CV was 2.0-2.2 times of BV in group C.Conclusion CV is predictable by the BV and the ratio of Pmax to BV.It can reduce the rate of the leakage,and also can prevent the unsatisfactory results by insufficient bone cement volume.
