CAJ | 학술논문

目的：对比高黏度与低黏度骨水泥经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折（OVCF）的疗效差异。方法将2013年3月至2014年9月高要市人民医院收治的60例OVCF患者采用随机抽签法分为低黏度组（低黏度骨水泥PKP治疗）和高黏度组（高黏度骨水泥PKP治疗），每组各30例。对比两组手术前后伤椎椎体高度和后凸Cobb角；采用视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）、36项健康调查简表（SF-36）评分对患者疼痛程度、功能障碍和生活质量等主观感受进行评价；统计骨水泥渗漏、近期肺栓塞等并发症发生情况。结果低黏度组和高黏度组骨水泥注入量分别为（3.1±0.6）mL和（3.6±0.8）mL，两组比较，差异有统计学意义（P＜0.05）。术后随访3～6个月（平均4个月），两组术后1 d、3个月VAS评分、ODI、SF-36评分、伤椎椎体高度和后凸Cobb角均优于术前（P＜0.05），其中高黏度组术后1 d、3个月上述指标均优于低黏度组（P＜0.05）。低黏度组和高黏度组术后发生骨水泥渗漏、近期肺栓塞分别为6、2例和1、0例，两组并发症发生率比较，差异有统计学意义（P＜0.05）。结论与低黏度骨水泥比较，高黏度骨水泥PKP治疗OVCF近期疗效更为理想，骨水泥渗漏、近期肺栓塞等并发症发生率相对较低，值得临床推广应用。
목적：대비고점도여저점도골수니경피추체후철성형술（PKP）치료골질소송성추체압축성골절（OVCF）적료효차이。방법장2013년3월지2014년9월고요시인민의원수치적60례OVCF환자채용수궤추첨법분위저점도조（저점도골수니PKP치료）화고점도조（고점도골수니PKP치료），매조각30례。대비량조수술전후상추추체고도화후철Cobb각；채용시각모의량표（VAS）평분、Oswestry공능장애지수（ODI）、36항건강조사간표（SF-36）평분대환자동통정도、공능장애화생활질량등주관감수진행평개；통계골수니삼루、근기폐전새등병발증발생정황。결과저점도조화고점도조골수니주입량분별위（3.1±0.6）mL화（3.6±0.8）mL，량조비교，차이유통계학의의（P＜0.05）。술후수방3～6개월（평균4개월），량조술후1 d、3개월VAS평분、ODI、SF-36평분、상추추체고도화후철Cobb각균우우술전（P＜0.05），기중고점도조술후1 d、3개월상술지표균우우저점도조（P＜0.05）。저점도조화고점도조술후발생골수니삼루、근기폐전새분별위6、2례화1、0례，량조병발증발생솔비교，차이유통계학의의（P＜0.05）。결론여저점도골수니비교，고점도골수니PKP치료OVCF근기료효경위이상，골수니삼루、근기폐전새등병발증발생솔상대교저，치득림상추엄응용。
Objective To compare the curative effect of high-viscosity and low-viscosity bone cement in percutaneous kyphoplasty (PKP) for the treatment of osteoporotic vertebral compression fracture (OVCF). Methods Sixty OVCF patients treated by PKP from March 2013 to September 2014 in Gaoyao People's Hospital were randomly divided into low-viscosity group (treated by low-viscosity bone cement PKP) and high-viscosity group (treated by high-viscosity bone cement PKP), with 30 patients in each group. The height of involving vertebrae and kyphosis Cobb angle in two groups were compared before and after operation; Visual analogue scale (VAS), Oswestry disability index (ODI) and 36-item short form health survey questionnaires (SF-36) score were adopted to evaluate the pain degree, dysfunction, quality of life and other subjective sensations of the patients; Complications such as bone cement leakage and recent pulmonary embolism were also recorded. Results The injected bone cement volume in low-viscosity group and high-viscosity group were (3.1 ± 0.6) mL and (3.6 ± 0.8) mL respectively, the difference was statistically significant (P <0.05). The patients were followed up for 3-6 months (the average was 4 months). VAS score, ODI, SF-36 score, vertebral height and kyphosis Cobb angle in two groups at 1 d and 3 months after the surgery were better than preoperative ones (P<0.05). Among them, the above postoperative indicators in high-viscosity group at 1 day and 3 months after the operation were better than those in low-viscosity group (P <0.05). Bone cement leakage and recent pulmonary embolism occurred in 6, 2 cases in low-viscosity group and 1, 0 cases in high-viscosity one, showing statistical differences of complication incidences between two groups (P <0.05). Conclusion Compared with low-viscosity bone cement PKP, short-term efficacy of high-viscosity bone cement PKP in the treatment of OVCF is more ideal with lower complications of bone cement leakage and recent pulmonary embolism, which is worthy of clinical application and popularization.