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[1]李洪珂,郝申申,董勝利,等.手法復位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的臨床研究[J].中醫(yī)正骨,2020,32(08):6-11.
　LI Hongke,HAO Shenshen,DONG Shengli,et al.A clinical study of manipulative reduction combined with percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(08):6-11.
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手法復位聯(lián)合經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年08期
頁碼:
6-11
欄目:
臨床研究
出版日期:
2020-08-20

文章信息/Info

Title:
A clinical study of manipulative reduction combined with percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures
作者:
李洪珂; 郝申申; 董勝利; 劉帥; 陳紅磊; 張志芳; 王鵬程; 楊賢玉; 郭阿雷
(平煤神馬醫(yī)療集團總醫(yī)院,河南 平頂山 467000)
Author(s):
LI Hongke; HAO Shenshen; DONG Shengli; LIU Shuai; CHEN Honglei; ZHANG Zhifang; WANG Pengcheng; YANG Xianyu; GUO Alei
General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,Henan,China
關(guān)鍵詞:
脊柱骨折;  胸椎;  腰椎;  骨折; 壓縮性;  骨質(zhì)疏松性骨折;  正骨手法;  椎體成形術(shù);  椎體后凸成形術(shù);  臨床試驗
Keywords:
spinal fractures;  thoracic vertebrae;  lumbar vertebrae;  fractures; compression;  osteoporotic fractures;  bone setting manipulation;  vertebroplasty;  kyphoplasty;  clinical trial
摘要:
目的:探討手法復位聯(lián)合經(jīng)皮椎體成形術(shù)(percutaneous vertebroplasty,PVP)治療骨質(zhì)疏松性椎體壓縮骨折(osteoporotic vertebral compression fracture,OVCF)的臨床療效和安全性。方法:回顧性分析80例OVCF患者的病例資料,根據(jù)采用的治療方法分為3組,采用手法復位聯(lián)合PVP治療28例、采用手法復位聯(lián)合經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)治療25例、采用單純PKP治療27例。比較3組患者的手術(shù)時間、術(shù)中透視次數(shù)、骨水泥分布情況、骨水泥滲漏情況、腰背部疼痛視覺模擬量表(visual analogue scale,VAS)評分、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)評分。結(jié)果:3組患者手術(shù)時間、術(shù)中透視次數(shù)、骨水泥分布情況比較,組間差異均有統(tǒng)計學意義(F=4.424,P=0.015; F=5.584,P=0.004; Z=13.759,P=0.001)。手法復位聯(lián)合PVP組手術(shù)時間短于手法復位聯(lián)合PKP組和單純PKP組(P=0.008; P=0.019); 手法復位聯(lián)合PKP組和單純PKP組手術(shù)時間的差異無統(tǒng)計學意義(P=0.724)。手法復位聯(lián)合PVP組術(shù)中透視次數(shù)少于手法復位聯(lián)合PKP組和單純PKP組(P=0.001; P=0.019); 手法復位聯(lián)合PKP組和單純PKP組術(shù)中透視次數(shù)的差異無統(tǒng)計學意義(P=0.348)。手法復位聯(lián)合PKP組的骨水泥分布情況最優(yōu),手法復位聯(lián)合PVP組次之,單純PKP組最差(R^-1=33.94; R^-2=34.39; R^-3=52.92)。3組患者治療前、治療后1周的腰背部疼痛VAS評分比較,組間差異無統(tǒng)計學意義(F=0.186,P=0.830; F=0.988,P=0.376); 3組患者治療后1周的腰背部疼痛VAS評分均顯著低于治療前[(7.5±1.3)分,(2.0±0.5)分,t=20.894,P=0.000;(7.7±1.5)分,(2.0±0.7)分,t=16.613,P=0.000;(7.7±1.4)分,(2.2±0.6)分,t=18.762,P=0.000]。3組患者治療前、治療后1周的ODI評分比較,組間差異無統(tǒng)計學意義(F=0.375,P=0.688; F=0.728,P=0.485)。3組患者治療后1周的ODI評分均顯著低于治療前[(40.2±7.5)分,(20.4±7.4)分,t=9.944,P=0.000;(41.5±7.3)分,(20.1±7.0)分,t=10.579,P=0.000;(41.8±7.0)分,(22.3±7.2)分,t=10.090,P=0.000]。手法復位聯(lián)合PVP組2例骨水泥滲漏,手法復位聯(lián)合PKP組1例骨水泥滲漏,單純PKP組2例骨水泥滲漏,均在暫停注入后停止?jié)B漏,調(diào)整注入位點后完成骨水泥注入; 3組患者骨水泥滲漏率比較,組間差異無統(tǒng)計學意義(χ2=0.316,P=0.854)。術(shù)中無刺破椎體、神經(jīng)血管損傷、醫(yī)源性骨折。結(jié)論:手法復位聯(lián)合PVP治療OVCF與手法復位聯(lián)合PKP、單純PKP治療的短期臨床療效與安全性相當,但手法復位聯(lián)合PVP治療OVCF的手術(shù)時間短、術(shù)中透視次數(shù)少,且骨水泥分布好。
Abstract:
To explore the clinical curative effects and safety of manipulative reduction combined with percutaneous vertebroplasty(PVP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:The medical records of 80 OVCF patients were analyzed retrospectively.The patients were divided into three groups according to the therapies they received.Twenty-eight patients were treated with manipulative reduction combined with PVP(group A),25 patients were treated with manipulative reduction combined with percutaneous kyphoplasty(PKP)(group B),while the others were treated with monotherapy of PKP(group C).The operative time,intraoperative X-ray exposure,bone cement distribution,bone cement leakage,low back pain visual analogue scale(VAS)scores and Oswestry disability index(ODI)scores were compared between the 3 groups.Results:There was statistical difference in operative time,intraoperative

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中醫(yī)正骨2020年8月第32卷第8期 J Trad Chin Orthop Trauma,2020,Vol.32,No.8(總571)
(總572)中醫(yī)正骨2020年8月第32卷第8期 J Trad Chin Orthop Trauma,2020,Vol.32,No.8
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通訊作者:郝申申 E-mail:[email protected]
更新日期/Last Update: 2020-08-20