术前垫枕联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折的效果评价

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摘要目的探讨术前垫枕联合经皮椎体成形术（PVP）治疗骨质疏松性胸腰椎压缩性骨折的临床应用效果。方法选取2014年2月～2017年6月我院收治的60例骨质疏松性胸腰椎压缩性骨折患者，采用随机数字表法将其分为对照组、研究组，每组30例。对照组予以PVP治疗，研究组予以术前垫枕联合PVP治疗。比较两组患者的临床疗效以及术前、术后3 d，3、6个月的疼痛视觉模拟量表（VAS）评分、椎前缘高度压缩率、椎中部高度压缩率、Cobb角变化情况。结果研究组患者的临床总有效率显著高于对照组，差异有统计学意义（P<0.05）。术前、术后3 d，两组患者VAS评分的比较，差异无统计学意义（P＞0.05），两组患者的术后3、6个月的VAS评分显著低于术前，且研究组患者的术后3、6个月的VAS评分低于对照组，差异有统计学意义（P<0.05）。术前，两组患者的椎前缘高度压缩率的比较，差异无统计学意义（P＞0.05），两组术后3 d，3、6个月的椎前缘高度压缩率均显著低于术前，且研究组患者的椎前缘高度压缩率显著低于对照组，差异有统计学意义。术前，两组患者椎中部高度压缩率的比较，差异无统计学意义（P＞0.05），研究组术后3 d，3、6个月时椎中部高度压缩率均显著低于术前，且研究组患者的椎中部高度压缩率显著低于对照组（P＜0.05），对照组术后3 d的椎中部高度压缩率显著低于术前，差异有统计学意义（P<0.05）。术前，两组患者不同时期Cobb角的比较，差异无统计学意义（P＞0.05），两组患者的术后3 d，3、6个月的 Cobb角均显著低于术前，且研究组患者的Cobb角显著低于对照组，差异有统计学意义（P<0.05）。结论术前垫枕联合PVP治疗骨质疏松性胸腰椎压缩性骨折可显著缓解患者疼痛感，恢复椎体高度及矫正Cobb角畸形，疗效确切。

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	陈文盛
	申连成
	龙厚才
	方晓婷

关键词 ：骨质疏松, 胸腰椎压缩性骨折, 经皮椎体成形术, 垫枕

Abstract：ObjectiveTo investigate the clinical effect of preoperative pillow and percutaneous vertebroplasty　(PVP)in the treatment of osteoporotic thoracolumbar vertebral compression fractures.MethodsSixty patients with osteoporotic thoracolumbar vertebral compression fractures admitted to our hospital from February 2014 to June 2017 were selected and divided into control group and study group with 30 cases in each group by random number table method.The control group was treated with PVP,while the study group was treated with preoperative pillow and PVP.The clinical efficacy of the two groups were compared,as well as the vas scores,vertebral anterior height compression ratio,vertebral central height compression ratio and Cobb angle changes before and after 3 d,3 and 6 months.ResultsThe total clinical effective rate in the study group was significantly higher than that in the control group(P<0.05).There was no statistically significant difference in vas scores between the two groups before surgery and 3 days　(P>0.05).The VAS scores of the two groups at 3 and 6 months after surgery were significantly lower than those before surgery,and the VAS scores of the study group at 3 and 6 months after surgery were lower than those of the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference between the two groups　(P>0.05)in the compression ratio of the height of the anterior vertebral edge.The compression ratio of the height of the anterior verte-bral edge of the two groups at 3 d,3 and 6 months after surgery was significantly lower than that before surgery,and the compression ratio of the height of the anterior vertebral edge of the patients in the study group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).Before surgery,there was no statistical difference between the two groups(P>0.05).at 3 d,3 and 6 months after surgery,the compression ratio of the height of the middle vertebra in the study group was significantly lower than that before surgery,and the compression ratio of the height of the middle vertebra in the study group was significantly lower than that in the control group，the difference was statistically significant(P<0.05).The compression ratio of the height of the middle vertebra in the control group at 3 d after surgery was significantly lower than that before surgery,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in Cobb angle between the two groups at different stages,the difference was statistically significant(P>0.05).The Cobb angle of the two groups at 3 d,3 and 6 months after surgery was significantly lower than that before surgery,and the Cobb angle of the study group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).ConclusionThe treatment of osteoporotic thoracic and lumbar vertebral compression fractures with anterior cushion and PVP can significantly relieve pain,restore height of vertebral body and correct Cobb angle malformation.The curative effect is definite.

Key words： Osteoporosis Thoracolumbar compression fractures Percutaneous vertebroplasty Pillow

引用本文:

陈文盛；　申连成；　龙厚才；　方晓婷. 术前垫枕联合经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折的效果评价[J]. 中国当代医药, 2018, 25(17): 62-65.
CHEN Wen-sheng；　SHEN Lian-cheng；　LONG Hou-cai ；FANG Xiao-ting. Evaluation of the effect of preoperative pillow and percutaneous vertebrop lasty in the treatment of osteoporotic thoracolumbar com pression fractures. 中国当代医药, 2018, 25(17): 62-65.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I17/62

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