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[1]徐無忌,劉曉嵐.體位復(fù)位結(jié)合經(jīng)皮椎體成形術(shù)與經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的對(duì)比研究[J].中醫(yī)正骨,2016,28(07):20-24.
　XU Wuji,LIU Xiaolan.Effect of Qianggu Yin(強(qiáng)骨飲,QGY)on bone microstructure in the ovariectomized osteoporosis rats[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(07):20-24.
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體位復(fù)位結(jié)合經(jīng)皮椎體成形術(shù)與經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年07期
頁碼:
20-24
欄目:
胸腰椎骨折
出版日期:
2016-07-20

文章信息/Info

Title:
Effect of Qianggu Yin(強(qiáng)骨飲,QGY)on bone microstructure in the ovariectomized osteoporosis rats
作者:
徐無忌; 劉曉嵐
湖南中醫(yī)藥大學(xué)第二附屬醫(yī)院,湖南 長(zhǎng)沙 410005
Author(s):
XU Wuji; LIU Xiaolan
The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410005,Hunan,China
關(guān)鍵詞:
脊柱骨折;  骨質(zhì)疏松性骨折;  骨折; 壓縮性;  正骨手法;  椎體成形術(shù);  椎體后凸成形術(shù);  臨床試驗(yàn)
Keywords:
spinal fractures;  osteoporotic fractures;  fractures; compression;  bone setting manipulation;  vertebroplasty;  kyphoplasty;  clinical trail
摘要:
目的:比較體位復(fù)位結(jié)合經(jīng)皮椎體成形術(shù)(percutaneous vertebroplasty,PVP)與經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)治療骨質(zhì)疏松性椎體壓縮骨折的臨床療效及安全性。方法:2009年1月至2014年1月收治175例骨質(zhì)疏松性椎體壓縮骨折患者,其中82例采用體位復(fù)位結(jié)合PVP治療(聯(lián)合治療組),93例采用PKP治療(PKP組)。比較2組患者的手術(shù)時(shí)間、術(shù)中透視次數(shù)、住院時(shí)間、治療費(fèi)用、疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分、Cobb's角、鄰近椎體骨折發(fā)生率和骨水泥滲漏率。結(jié)果:聯(lián)合治療組的手術(shù)時(shí)間、術(shù)中透視次數(shù)、治療費(fèi)用均低于PKP組[(30.134±7.503)min,(55.215±12.781)min,t=-16.046,P=0.000;(15.610±1.322)次,(20.366±3.653)次,t=-11.716,P=0.000;(15 078.146±1 149.556)元,(31 659.765±1 662.886)元,t=-77.440,P=0.000]; 2組患者的住院時(shí)間比較,差異無統(tǒng)計(jì)學(xué)意義[(4.549±1.167)d,(4.580±0.889)d,t=-0.205,P=0.838]; 術(shù)前及術(shù)后1個(gè)月2組患者的疼痛VAS評(píng)分、Cobb's角比較,組間差異均無統(tǒng)計(jì)學(xué)意義[(7.524±0.946)分,(7.441±1.272)分,t=0.487,P=0.627;(0.829±0.379)分,(0.817±0.388)分,t=0.207,P=0.836; 20.195°±3.802°,19.828°±3.479°,t=0.667,P=0.506; 5.354°±1.828°,4.882°±1.276°,t=1.995,P=0.053],且術(shù)后1個(gè)月時(shí)2組患者的疼痛VAS評(píng)分和Cobb's角均較術(shù)前減小(t=62.030,P=0.000; t=49.081,P=0.000; t=33.665,P=0.000; t=40.132,P=0.000)。至術(shù)后12個(gè)月時(shí)聯(lián)合治療組發(fā)生鄰近椎體骨折8例,PKP組發(fā)生鄰近椎體骨折11例,2組患者的鄰近椎體骨折發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.193,P=0.660); 聯(lián)合治療組19椎發(fā)生骨水泥滲漏,PKP組16椎發(fā)生骨水泥滲漏,2組患者的骨水泥滲漏發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(χ2=0.934,P=0.334)。結(jié)論:體位復(fù)位結(jié)合PVP手術(shù)與單純PKP手術(shù)均可有效緩解骨質(zhì)疏松性椎體壓縮骨折患者的疼痛癥狀、恢復(fù)傷椎形態(tài),二者的療效及安全性相當(dāng),但前者具有手術(shù)時(shí)間短、術(shù)中透視次數(shù)少及治療費(fèi)用低的優(yōu)勢(shì)。
Abstract:
Objective:To compare the clinical curative effect and safety between postural reduction combined with percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures.Methods:One hundred and seventy-five patients with osteoporotic vertebral compression fractures were recruited from January 2009 to January 2014.Eighty-two patients(combination treatment group)were treated with postural reduction combined with PVP,while the others(PKP group)were treated with PKP.The operative time,intraoperative X-ray exposure,hospital stay,cost of treatment,pain visual analogue scale(VAS)scores,Cobb's angle and incidence rate of adjacent vertebral fractures and bone cement leakage were compared between the 2 groups.Results:The operative time,intraoperative X-ray exposure and cost of treatment were less in combination treatment group compared to PKP group(30.134+/-7.503 vs 55.215+/-12.781 min,t=-16.046,P=0.000; 15.610+/-1.322 vs 20.366+/-3.653 times,t=-11.716,P=0.000; 15 078.146+/-1 149.556 vs 31 659.765+/-1 662.886 RMB,t=-77.440,P=0.000).There was no statistical difference in hospital stay between the 2 groups(4.549+/-1.167 vs 4.580+/-0.889 days,t=-0.205,P=0.838).There was no statistical difference in pain VAS scores and Cobb's angle between the 2 groups before surgery and at 1 month after the surgery(7.524+/-0.946 vs 7.441+/-1.272 points,t=0.487,P=0.627; 0.829+/-0.379 vs 0.817+/-0.388 points,t=0.207,P=0.836; 20.195+/-3.802 vs 19.828+/-3.479 degrees,t=0.667,P=0.506; 5.354+/-1.828 vs 4.882+/-1.276 degrees,t=1.995,P=0.053).The pain VAS scores and Cobb's angle decreased in both of the 2 groups at 1 month after the surgery compared to pre-surgery(t=62.030,P=0.000; t=49.081,P=0.000; t=33.665,P=0.000; t=40.132,P=0.000).The adjacent vertebral fractures were found in combination treatment group(8)and PKP group(11)at 12 month after the surgery,and there was no statistical difference in the incidence rate of adjacent vertebral fractures between the 2 groups(χ2=0.193,P=0.660).The bone cement leakage were found in combination treatment group(19)and PKP group(16),and there was no statistical difference in the incidence rate of bone cement leakage between the 2 groups(χ2=0.934,P=0.334).Conclusion:Both combination thearpy of postural reduction and PVP and monotherapy of PKP can effectively relieve the pain and restore the morphous of injured vertebrae in the treatment of osteoporotic vertebral compression fractures.They are similar to each other in curative effect and safety,however,the former has such advantages as shorter operative time,less intraoperative X-ray exposure and lower cost of treatment.

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備注/Memo

備注/Memo:
2016-04-18收稿 2016-05-26修回
徐無忌 E-mail:[email protected]

更新日期/Last Update: 1900-01-01