| 张罗雅,张建,聂海,等.椎体强化术治疗超高龄骨质疏松性椎体压缩骨折病人的生存质量分析.骨科,2025,16(1): 8-13. |
| 椎体强化术治疗超高龄骨质疏松性椎体压缩骨折病人的生存质量分析 |
| Analysis of quality of life in super-aged patients with osteoporotic vertebral compression fractures treated with vertebral augmentation |
| 投稿时间：2024-05-31 |
| DOI：10.3969/j.issn.1674-8573.2025.01.002 |
| 中文关键词: 骨质疏松性椎体压缩骨折 椎体强化术 保守治疗 生存质量 世界卫生组织生存质量测定量表简表 |
| 英文关键词: Osteoporotic vertebral compression fracture Vertebral augmentation Conservative treatment Quality of life WHOQOL-BREF |
| 基金项目:德阳市第二人民医院-西南医科大学科技战略合作项目（2022DYEXNYD003、2022DYEXNYD007） |
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| 中文摘要: |
| 目的 分析椎体强化术治疗超高龄骨质疏松性椎体压缩骨折（OVCFs）病人的生存质量，探讨影响超高龄OVCFs病人生存质量的相关因素。方法 回顾性分析2022年1月至2023年3月在西南医科大学附属医院接受椎体强化术治疗或保守治疗的47例超高龄OVCFs病人的临床资料，根据治疗方式分为手术组（30例，接受椎体强化术治疗）和对照组（17例，接受保守治疗）。比较两组病人的基线资料，记录并比较治疗前、治疗后1周、3个月及末次随访的腰背部疼痛视觉模拟量表（VAS）评分，治疗前和治疗后12个月骨密度T值，治疗前和末次随访时世界卫生组织生存质量测定量表简表（WHOQOL-BREF）得分。利用线性相关分析法分析两组病人末次随访时WHOQOL-BREF量表得分与病人基线资料的相关性。结果 47例病人均完成随访，随访时间12~18个月，无失访、死亡等情况。手术组出现骨水泥轻微渗漏1例，随访期间病人未出现不适；对照组发生骶尾部压疮2例、尿路感染2例，肺部感染1例，予以对症治疗后症状均缓解。两组病人治疗后VAS评分、治疗后12个月骨密度T值和末次随访WHOQOL-BREF量表得分均较治疗前好转（P＜0.05）；与对照组相比，手术组VAS评分显著降低、WHOQOL-BREF量表总分显著升高，差异有统计学意义（P＜0.05）；两组治疗后12个月的骨密度T值比较，差异无统计学意义（P＞0.05）。相关性分析显示在两组中，年龄、骨折椎体数量、治疗前VAS评分与末次随访WHOQOL-BREF量表得分呈负相关，骨密度T值、治疗前WHOQOL-BREF量表得分与末次随访WHOQOL-BREF量表得分呈正相关。结论 椎体强化术和保守治疗均能有效提高超高龄OVCFs病人的生存质量，但椎体强化术能更明显地提高病人生存质量，同时还能快速缓解超高龄OVCFs病人疼痛症状。病人的年龄、骨质状况、骨折椎体数量、伤后VAS评分及治疗前的生存质量是影响病人治疗后生存质量恢复情况的重要因素。 |
| 英文摘要: |
| Objective To analyze the quality of life of super-aged osteoporotic vertebral compression fractures (OVCFs) patients treated with vertebral augmentation, and to explore the related factors influencing the quality of life of super-aged OVCF patients. Methods The clinical data of 47 super-aged patients with OVCFs who underwent vertebral augmentation and conservative treatment in the Affiliated Hospital of Southwest Medical University from January 2022 to March 2023 were retrospectively analyzed. According to the treatment methods, the patients were divided into surgery group (30 cases, treated with vertebral augmentation) and control group (17 cases, treated with conservative treatment). The baseline data of the two groups were compared, and the visual analogue scale (VAS) of low back pain before treatment, 1 week, 3 months after treatment and at the last follow-up were recorded and compared. The T value of bone mineral density before treatment and 12 months after treatment was recorded and compared. The scores of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) before treatment and at the last follow-up were compared. Correlation analysis was used to analyze the correlation between the scores of WHOQOL-BREF at the last follow-up and the general information of the two groups. Results All 47 patients were followed up for 12-18 months, and there was no loss of follow-up or death. There was 1 case of slight cement leakage in the surgery group, and the patient did not feel uncomfortable during the follow-up period. In control group, 2 patients had sacrococcygeal pressure ulcers, 2 patients had urinary tract infection, and 1 patient had pulmonary infection, and the symptoms were relieved after symptomatic treatment. Compared before treatment, the VAS score, T value of bone mineral density at 12 months after treatment and WHOQOL-BREF score at the last follow-up were improved in the two groups (P＜0.05), and the VAS score in the surgery group was lower and the WHOQOL-BREF score was higher than that in the control group (P＜0.05). At 12 months after treatment, there was no significant difference in bone mineral density T value between the two groups (P＞0.05). Correlation analysis showed that age, number of fractured vertebrae and VAS score before treatment were negatively correlated with WHOQOL-BREF score at the last follow-up, while T value of bone mineral density and WHOQOL-BREF score before treatment were positively correlated with WHOQOL-BREF score at the last follow-up. Conclusion Both vertebral augmentation and conservative treatment can effectively improve the quality of life of super-aged OVCFs patients, but vertebral augmentation can improve the quality of life of patients more significantly, and can quickly relieve the pain symptoms of super-aged OVCFs patients. Age, bone status, number of fractured vertebrae, VAS score after injury and quality of life before treatment are important factors influencing the recovery of quality of life after treatment. |
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