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1、經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮性骨折作者:梅盛前,陳其昕,徐利明,蘭俊摘要:目的探討經(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效果。方法自2004年1月至2004年9月采用經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折患者21例,與同期保守治療的19例患者進(jìn)行對(duì)比研究。結(jié)果經(jīng)皮椎體成形術(shù)組與保守治療組相比,住院時(shí)間明顯縮短,患者癥狀緩解較早,早期可開始下床活動(dòng)(P<0.01),所有病例傷椎前緣高度恢復(fù)明顯,經(jīng)統(tǒng)計(jì)學(xué)分析差異有顯著性(P<0.05),而后凸Cobb角矯正不明顯,差異無統(tǒng)計(jì)學(xué)意義(P>0.05),隨訪6~12個(gè)月(平均8個(gè)月)后未見明顯傷椎高度丟失。結(jié)論經(jīng)皮椎
2、體成形術(shù)是一種簡(jiǎn)單、微創(chuàng)、安全有效的治療方法,但要掌握其應(yīng)用的適應(yīng)證?! £P(guān)鍵詞:經(jīng)皮椎體成形術(shù);椎體壓縮骨折;骨質(zhì)疏松;治療 TreatmentofOsteoporoticVertebralCompressionFractureswithPercutaneousVertebroplasty Abstract:ObjectiveToinvestigatetheclinicaloutcomesinthetreatmentofOsteoporoticVertebralCompres-sionFractureswithPercutaneousVertebroplasty(PVP).Methods
3、Theclinicalresultsofagroupof21patients,whohadsufferedfromtheOsteoporoticVertebralCompressionFracturesandtreatedwithPercutaneousVertebro-plasty,werecomparedFracturesandtreatedwithPercutaneousVertebroplasty,werecomparedwithanothergroupof19patientstreatedbynon-operativeprocedure.ResultsThedurationofhos
4、pitalization,thetimeofpainremis-sionandtheoutofbedactivityweresignificantlyreducedinthePVP.groupascomparedwiththoseundergonenon-operativeprocedure(P<0.01).Onfollowingupfromsixmonthstotwelevemonths,theanteriorheightofinjuredvertebralbodyofallpatientsweregenerallyrecoveredobviously(P<0.05),andth
5、eCobbangleswerenotrectifiedobviously(P>0.05).ConclusionThePVPisaneffectiveprocedureofsimplemicroinjure,withlesscomplication,wideindicationandgoodoutcome,anditisessentialtomasteritsindicationmeanwhile. Keywords:percutaneousvertebroplasty;vertebralcompressionfracture;osteoporotic;treatment5 骨質(zhì)疏松癥
6、的患者日益增多,而脊柱壓縮性骨折是骨質(zhì)疏松癥的常見并發(fā)癥。多數(shù)骨折會(huì)在幾周或幾個(gè)月內(nèi)愈合,但部分患者會(huì)留有持續(xù)性腰背疼痛癥狀,嚴(yán)重影響了患者的生活質(zhì)量。經(jīng)皮椎體成形術(shù)(percutaneousvertebroplasty,PVP)是經(jīng)皮穿刺通過椎弓根向椎體內(nèi)注入骨水泥,以達(dá)到恢復(fù)椎體高度,增強(qiáng)椎體強(qiáng)度,防止塌陷,緩解腰背部疼痛的目的。我院自2004年1月至2004年9月采用經(jīng)皮椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折患者21例,與同期保守治療的19例患者進(jìn)行對(duì)比研究,結(jié)果充分肯定了經(jīng)皮椎體成形術(shù)的優(yōu)越性,現(xiàn)報(bào)告如下?! ?材料與方法 1.1一般資料 1.1.1椎體成形組本組共21例,其中男7例
7、,女14例;年齡61~79歲,平均66.8歲。損傷節(jié)段:T128例,L19例,L22例,L32例?;颊呔鶠閱渭儔嚎s性骨折,傷椎前緣高度為(20.6±4.4)mm,后凸Cobb角(傷椎上位椎體下終板與傷椎下位椎體上終板夾角)為(7.2±4.1)°,術(shù)前均有不同程度的腰背部或骶髂部疼痛,無神經(jīng)受壓癥狀。手術(shù)時(shí)間均為傷后3~5d?! ?.1.2保守治療組本組19例患者,男8例,女11例;年齡63~76歲