84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]陳建德,樊曉琦,夏炳江,等.球囊擴(kuò)張部位對(duì)椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折療效及安全性的影響[J].中醫(yī)正骨,2017,29(02):11-16.
　CHEN Jiande,FAN Xiaoqi,XIA Bingjiang,et al.Influence of balloon dilation position on curative effect and safety of percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(02):11-16.
點(diǎn)擊復(fù)制

球囊擴(kuò)張部位對(duì)椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折療效及安全性的影響()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年02期
頁(yè)碼:
11-16
欄目:
臨床研究
出版日期:
2017-02-20

文章信息/Info

Title:
Influence of balloon dilation position on curative effect and safety of percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures
作者:
陳建德; 樊曉琦; 夏炳江; 凌義龍
浙江省紹興市中醫(yī)院,浙江 紹興 312300
Author(s):
CHEN Jiande; FAN Xiaoqi; XIA Bingjiang; LING Yilong
Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312300,Zhejiang,China
關(guān)鍵詞:
骨質(zhì)疏松性骨折;  脊柱骨折;  椎體后凸成形術(shù);  臨床試驗(yàn)
Keywords:
osteoporotic fractures;  spinal fractures;  kyphoplasty;  clinical trial
摘要:
目的:探討經(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(osteoporotic vertebral compression fractures,OVCF)時(shí),球囊擴(kuò)張部位對(duì)手術(shù)療效及安全性的影響。方法:回顧性分析47例采用PKP治療的新鮮單節(jié)段OVCF患者的病例資料。24例球囊擴(kuò)張部位位于骨折線處(骨折線組),其余23例球囊擴(kuò)張部位未位于骨折線處(非骨折線組)。比較2組患者的傷椎前緣高度、疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)評(píng)分及治療、隨訪期間的并發(fā)癥發(fā)生情況。結(jié)果:所有患者均順利完成手術(shù),未發(fā)生脊髓、神經(jīng)根損傷及肺栓塞等并發(fā)癥; 9例發(fā)生骨水泥滲漏,其中骨折線組3例向側(cè)前方滲漏、2例向椎間盤(pán)滲漏,非骨折線組向側(cè)前方和椎間盤(pán)滲漏各2例,9例患者均未出現(xiàn)臨床癥狀。2組患者并發(fā)癥發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.000,P=1.000)。手術(shù)前后不同時(shí)間傷椎前緣高度的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=117.624,P=0.000); 2組患者傷椎前緣高度總體上比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=4.127,P=0.048); 除術(shù)前外[(18.69±3.17)mm,(18.70±2.96)mm,t=0.451,P=0.654],術(shù)后3 d和術(shù)后3個(gè)月時(shí)骨折線組的傷椎前緣高度均大于非骨折線組[(21.56±1.57)mm,(20.30±1.98)mm,t=2.127,P=0.039;(21.42±1.54)mm,(20.14±2.00)mm,t=2.145,P=0.037]。時(shí)間因素與分組因素存在交互效應(yīng)(F=9.808,P=0.003)。手術(shù)前后不同時(shí)間疼痛VAS評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=760.314,P=0.000); 2組疼痛VAS評(píng)分總體上比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=4.911,P=0.032); 除術(shù)前外[(7.96±0.86)分,(7.78±0.95)分,t=0.665,P=0.509],術(shù)后3 d和術(shù)后3個(gè)月時(shí)骨折線組的疼痛VAS評(píng)分均小于非骨折線組[(2.41±0.88)分,(2.95±0.93)分,t=2.046,P=0.047;(2.08±0.78)分,(2.56±0.73)分,t=2.194,P=0.033]。時(shí)間因素與分組因素存在交互效應(yīng)(F=3.119,P=0.049)。手術(shù)前后不同時(shí)間ODI評(píng)分的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)(F=2 018.591,P=0.000); 2組ODI評(píng)分總體上比較,組間差異有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=4.168,P=0.047); 除術(shù)前外[(39.54±2.23)分,(39.13±1.94)分,t=0.674,P=0.504],術(shù)后3 d和術(shù)后3個(gè)月時(shí)骨折線組的ODI評(píng)分均小于非骨折線組[(22.67±1.90)分,(24.35±2.32)分,t=2.716,P=0.009;(14.38±1.58)分,(15.61±1.44)分,t=2.793,P=0.008]。時(shí)間因素與分組因素存在交互效應(yīng)(F=4.014,P=0.021)。結(jié)論:采用PKP治療OVCF時(shí),在骨折處進(jìn)行球囊擴(kuò)張更有利于恢復(fù)傷椎高度、減輕疼痛、恢復(fù)功能,并且具有較高的安全性。
Abstract:
Objective:To explore the influence of balloon dilation position on curative effect and safety of percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:The medical records of 47 patients with fresh single-segment OVCF who were treated with PKP were analyzed retrospectively.The dilated balloon was placed at fracture line for 24 patients(fracture line group)and at other position for 23 patients(non-fracture line group).The injured vertebrae anterior border height,pain visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores and complications during the treatment period and follow-up period were compared between the 2 groups.Results:The surgery were finished successfully in all patients and no complications such as spinal cord injuries,nerve-root injuries and pulmonary embolism were found.The bone cement leakage were found in 9 patients,whlie no patient developed clinical symptoms.Anterolateral leakage(3)and leakage into intervertebral disc(2)were found in fracture line group,while anterolateral leakage(2)and leakage into intervertebral disc(2)were found in non-fracture line group.There was no statistical difference in complication incidences between the two groups(χ2=0.000,P=1.000).There was statistical difference in the injured vertebrae anterior border height between different timepoints,in other words,there was time effect(F=117.624,P=0.000).There was statistical difference in injured vertebrae anterior border height between the 2 groups in general,in other words,there was group effect(F=4.127,P=0.048).There was no statistical difference in injured vertebrae anterior border height between the 2 groups before the surgery(18.69+/-3.17 vs 18.70+/-2.96 mm,t=0.451,P=0.654).The injured vertebrae anterior border height were higher in fracture line group compared to non-fracture line group at 3 days and 3 months after the surgery(21.56+/-1.57 vs 20.30+/-1.98 mm,t=2.127,P=0.039; 21.42+/-1.54 vs 20.14+/-2.00 mm,t=2.145,P=0.037).There was interaction between time factor and group factor(F=9.808,P=0.003).There was statistical difference in the pain VAS scores between different timepoints,in other words,there was time effect(F=760.314,P=0.000).There was statistical difference in pain VAS scores between the 2 groups in general,in other words,there was group effect(F=4.911,P=0.032).There was no statistical difference in pain VAS scores between the 2 groups before the surgery(7.96+/-0.86 vs 7.78+/-0.95 points,t=0.665,P=0.509).The pain VAS scores were less in fracture line group compared to non-fracture line group at 3 days and 3 months after the surgery(2.41+/-0.88 vs 2.95+/-0.93 points,t=2.046,P=0.047; 2.08+/-0.78 vs 2.56+/-0.73 points,t=2.194,P=0.033).There was interaction between time factor and group factor(F=3.119,P=0.049).There was statistical difference in the ODI scores between different timepoints,in other words,there was time effect(F=2 018.591,P=0.000).There was statistical difference in ODI scores between the 2 groups in general,in other words,there was group effect(F=4.168,P=0.047).There was no statistical difference in ODI scores between the 2 groups before the surgery(39.54+/-2.23 vs 39.13±+/-1.94 points,t=0.674,P=0.504).The ODI scores were less in fracture line group compared to non-fracture line group at 3 days and 3 months after the surgery(22.67+/-1.90 vs 24.35+/-2.32 points,t=2.716,P=0.009; 14.38+/-1.58 vs 15.61+/-1.44 points,t=2.793,P=0.008).There was interaction between time factor and group factor(F=4.014,P=0.021).Conclusion:The balloon dilatation at fracture sites is conducive to alleviating pain and recovering height and function of injured vertebrae with high safety in treatment of OVCF by PKP.

參考文獻(xiàn)/References:

[1] BOONEN S,WAHL DA,NAUROY L,et al.Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures[J].Osteoporos Int,2011,22(12):2915-2934.
[2] 張文財(cái),秦豐偉,劉洪江,等.經(jīng)皮椎體后凸成形術(shù)研究進(jìn)展[J].中醫(yī)正骨,2013,25(8):64-67.
[3] JENSEN MP,KAROLY P,BRAVER S.The measurement of clinical pain intensity:a comparison of six methods[J].Pain,1986,27(1):117-126.
[4] FAIRBANK JC,PYNSENT PB.The oswestry disability index[J].Spine(Phila Pa 1976),2000,25(22):2940-2952.
[5] 任虎,申勇,楊大龍.經(jīng)皮椎體成形術(shù)的研究進(jìn)展[J].中國(guó)脊柱脊髓雜志,2009,19(5):392-394.
[6] KLAZEN CA,LOHLE PN,DE VRIES J,et al.Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures(Vertos II):an open-label randomised trial[J].Lancet,2010,376(9746):1085-1092.
[7] ALEXANDER NM,NISHIMOTO M.Protein-linked iodotyrosines in serum after topical application of povidone-iodine(Betadine)[J].J Clin Endocrinol Metab,1981,53(1):105-108.
[8] 楊建平,謝國(guó)華,薛峰,等.單球囊單、雙側(cè)擴(kuò)張經(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比較[J].中醫(yī)正骨,2014,26(3):21-24.
[9] 黃勝,許靖,項(xiàng)禹誠(chéng),等.單側(cè)與雙側(cè)入路經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松壓縮性骨折的比較研究[J].中國(guó)矯形外科雜志,2013,21(2):115-118.
[10] 王棟琪,汪兵,賀寶榮.骨質(zhì)疏松性椎體壓縮骨折行單雙側(cè)椎體后凸成形術(shù)的對(duì)比研究[J].脊柱外科雜志,2013,11(1):8-12.
[11] 方宜宥,周輝,彭亮,等.經(jīng)皮椎體后凸成形術(shù)中骨水泥滲漏的原因與預(yù)防策略[J].中醫(yī)正骨,2013,25(4):69-70.
[12] 李慶龍,吳愛(ài)憫,倪文飛,等.經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體骨折的常見(jiàn)并發(fā)癥分析[J].中醫(yī)正骨,2014,26(3):40-43.

相似文獻(xiàn)/References:

[1]張亮,張莉,王莉佳,等.快速康復(fù)外科理念在椎弓根螺釘內(nèi)固定治療 胸腰椎骨折圍手術(shù)期護(hù)理中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):75.
[2]潘雄,劉其順,應(yīng)行,等.中藥聯(lián)合4步康復(fù)鍛煉法對(duì)骨質(zhì)疏松性椎體壓縮 骨折患者生存質(zhì)量的影響[J].中醫(yī)正骨,2015,27(04):65.
[3]宋永枝,陳雙玲.唑來(lái)膦酸靜脈滴注聯(lián)合鮭降鈣素肌肉注射治療 骨質(zhì)疏松性長(zhǎng)骨骨折[J].中醫(yī)正骨,2016,28(01):70.
[4]孫蘭芬,王龍強(qiáng),劉潤(rùn)宏,等.頸椎骨折脫位合并脊髓損傷截癱患者的圍手術(shù)期護(hù)理[J].中醫(yī)正骨,2016,28(03):79.
[5]吳鵬,王博,孔令成,等.強(qiáng)骨飲顆粒聯(lián)合阿侖膦酸鈉維D3片口服在原發(fā)性骨質(zhì)疏松性髖部骨折術(shù)后抗骨質(zhì)疏松治療中的應(yīng)用[J].中醫(yī)正骨,2016,28(05):16.
　WU Peng,WANG Bo,KONG Lingcheng,et al.Oral application of Qiangguyin Keli(強(qiáng)骨飲顆粒)and alendronate sodium Vitamin D3 tablets in postoperative anti-osteoporosis treatment in patients with primary osteoporotic hip fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(02):16.
[6]梅 偉.胸腰椎骨折臨床診療中的熱點(diǎn)問(wèn)題[J].中醫(yī)正骨,2016,28(07):1.
[7]徐無(wú)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.
　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(02):20.
[8]李英周,葉鋒,王曉,等.后路撬撥植骨椎弓根螺釘內(nèi)固定治療胸腰椎骨折[J].中醫(yī)正骨,2016,28(07):46.
[9]王軍,陳哲,王碩凡.胸腰椎骨折椎體植骨材料的臨床應(yīng)用進(jìn)展[J].中醫(yī)正骨,2016,28(07):64.
[10]史曉林,王健,王博,等.脆性骨折的防治進(jìn)展[J].中醫(yī)正骨,2017,29(05):20.
[11]丁志清,顏峰,喻燦明,等.椎體后凸成形術(shù)后非典型骨水泥植入綜合征死亡1例[J].中醫(yī)正骨,2017,29(11):76.
[12]俞興,王婷,楊濟(jì)洲,等.經(jīng)皮椎體成形術(shù)和經(jīng)皮椎體后凸成形術(shù)治療Kmmell病的對(duì)比研究[J].中醫(yī)正骨,2018,30(06):23.
　YU Xing,WANG Ting,YANG Jizhou,et al.A retrospective trial of percutaneous vertebroplasty versus percutaneous kyphoplasty for treatment of Kmmell's diseases[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):23.
[13]彭小東,張曉剛,趙文韜,等.有限元分析在過(guò)伸復(fù)位治療骨質(zhì)疏松性椎體壓縮性骨折生物力學(xué)研究中的應(yīng)用進(jìn)展[J].中醫(yī)正骨,2018,30(07):25.
[14]陳建德,樊曉琦,凌義龍.單側(cè)椎弓根旁外側(cè)入路與雙側(cè)椎弓根入路 經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性胸椎 壓縮性骨折的對(duì)比研究[J].中醫(yī)正骨,2018,30(10):19.
　CHEN Jiande,FAN Xiaoqi,LING Yilong.A retrospective trial of percutaneous kyphoplasty through unilateral extrapedicular approach versus bilateral transpedicular approach for treatment of thoracic osteoporotic vertebral compression fracture[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):19.
[15]于東方,王祥善,張華,等.經(jīng)皮椎體成形術(shù)后手術(shù)椎體再骨折的病因、治療及預(yù)防[J].中醫(yī)正骨,2018,30(10):69.
[16]李兆勇,楊少鋒,張晨陽(yáng).補(bǔ)腎活血方聯(lián)合經(jīng)皮椎體強(qiáng)化術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的系統(tǒng)評(píng)價(jià)[J].中醫(yī)正骨,2019,31(03):28.
　LI Zhaoyong,YANG Shaofeng,ZHANG Chenyang.Oral application of Bushen Huoxue Fang(補(bǔ)腎活血方)combined with percutaneous vertebral augmentation for treatment of osteoporotic vertebral compression fractures:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(02):28.
[17]楊磊,崔宏勛,饒耀劍,等.彎角穿刺椎體成形裝置輔助下單側(cè)穿刺經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折[J].中醫(yī)正骨,2020,32(01):64.
[18]陳晨,安忠誠(chéng),張英健,等.椎體強(qiáng)化術(shù)后殘留腰背痛的研究進(jìn)展[J].中醫(yī)正骨,2020,32(05):26.
[19]劉銳,龔德飛,班正濤,等.經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折術(shù)中骨水泥滲漏的危險(xiǎn)因素分析[J].中醫(yī)正骨,2022,34(11):14.
　LIU Rui,GONG Defei,BAN Zhengtao,et al.Risk factors for bone cement leakage during percutaneous vertebroplasty treatment of osteoporotic vertebral compression fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):14.
[20]羅金金,丁彩田.骨質(zhì)疏松性椎體壓縮骨折經(jīng)皮椎體后凸成形術(shù)后脊柱后凸畸形改善程度的影響因素分析[J].中醫(yī)正骨,2022,34(08):8.
　LUO Jinjin,DING Caitian.Analysis of factors influencing the degree of improvement of spinal kyphosis deformity after percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):8.

備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省中醫(yī)藥(中西醫(yī)結(jié)合)重點(diǎn)學(xué)科建設(shè)項(xiàng)目(2012-XK-A32)
通訊作者:陳建德 E-mail:[email protected]
更新日期/Last Update: 2017-08-07