文章摘要
郑先念,张觅,谭俊峰,孙凯,刘洋,陈方舟.不同黏度骨水泥椎体成形术治疗骨质疏松性椎体压缩性骨折.骨科,2017,8(4):297-301
不同黏度骨水泥椎体成形术治疗骨质疏松性椎体压缩性骨折
Efficacy of high viscosity and low viscosity bone cement vertebral plasty for osteopororosis vertebral compression fractures
投稿时间: 2016-09-05  
DOI:10.3969/j.issn.1674-8573.2017.04.010
中文关键词: 高黏度骨水泥  低黏度骨水泥  椎体成形术  椎体压缩性骨折
英文关键词: High viscosity bone cement  Low viscosity bone cement  Vertebroplasty  Vertebral compression fractures
基金项目:卫生部医药科技发展中心资助项目(W2012ZT15)
作者单位E-mail
郑先念 430050 武汉武汉市第五医院急诊科  
张觅 430050 武汉武汉市第五医院急诊科  
谭俊峰 430050 武汉武汉市第五医院急诊科  
孙凯 430050 武汉武汉市第五医院急诊科  
刘洋 430050 武汉武汉市第五医院急诊科  
陈方舟 430050 武汉武汉市第五医院急诊科 346464372@qq.com 
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中文摘要:
      目的 比较采用高黏度骨水泥和低黏度骨水泥椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效差异。方法 回顾性分析2013年9月至2014年11月我科治疗的83例骨质疏松性椎体压缩性骨折病人的病例资料。根据手术所用不同黏度骨水泥分组:采用低黏度骨水泥椎体成形术治疗的病人43例(低黏度组);采用高黏度骨水泥椎体成形术治疗的病人40例(高黏度组)。记录单个椎体手术时间、骨水泥渗漏发生率,术后并发症发生率。采用疼痛视觉模拟量表(visual analogue scale, VAS)及Oswestry功能障碍指数(Oswestry disability index, ODI)对两组进行术前及术后1 d、术后3个月疼痛及功能进行评价。通过X线检查对术前、术后椎体各部进行测量,统计椎体高度变化。结果 83例病人术后均得到3个月随访。两组术前VAS评分和骨折压缩率上无差异。高黏度组的手术时间较低黏度组明显缩短(t=22.32,P=0.000)。术后1 d、术后3个月,两组组内VAS评分、ODI较术前明显降低(均P=0.000),但术后组间比较无明显差异(均P>0.05)。高黏度组骨水泥渗漏率较低黏度组低,差异有统计学意义(P=0.0494)。椎体成形术后高黏度组椎体高度恢复优于低黏度组,差异有统计学意义(P=0.000)。结论 椎体成形术中使用不同类型的骨水泥均能有效地缓解病人疼痛,改善生活质量。与低黏度骨水泥相比,高黏度骨水泥有着较低的骨水泥渗漏率,同时缩短了手术时间和降低了术中放射性的暴露。
英文摘要:
      Objective To compare the safety and effectiveness of two kinds of different vertebral plasty for osteoporosis vertebral compression fractures. Methods Eighty-three cases (83 vertebral bodies) of osteoporotic vertebral compression fractures were long-run investigated, including 43 patients given high viscosity bone cement treatment, and 40 patients given low viscosity bone cement. The single vertebral body piercing operation time, the volume of injected bone cement, the leakage of bone cement and the postoperative complications were recorded. The visual analogue scale (VAS) was used to measure the pain assessment of two groups, while oswestry disability index (ODI) was used to evaluate the pain and the motor function at the pre-operation, one day post-operation and three months post-operation. X-ray examination was done to measure the changes in the edge height of vertebrae before and after operation. The data were analyzed statistically by unpaired t-test. Results All 83 patients received a complete follow-up and the observation indexes were compared between two groups. There was no significant difference between high viscosity group and low viscosity group in the visual analogue scale, the vertebral compression ratio and the Oswestry disability index pre-operation. As compared with the low viscosity group, the operation time was shortened significantly in the high viscosity group (t=22.32, P=0.000). As compared with pre-operation, the visual analogue scale and the Oswestry disability index were decreased significantly at one day post-operation and three months post-operation in both the high viscosity group and the low viscosity group (P=0.000), while there was no significant difference between two groups. The high viscosity group demonstrated a significantly reduced incidence of cement leakage (P=0.0494) and better vertebral height restoration after vertebroplasty (P=0.000). Conclusion Both the high viscosity bone cement and the low viscosity bone cement have satisfactory therapeutic effects. As compared with low viscosity bone cement, high viscosity bone cement showed lower cement leakage incidence, shorter operative time and better vertebral height restoration.
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