目的：评估经皮椎体成形术（PVP）与经皮椎体后凸成形术（PKP）这两种微创手术方式在治疗骨质疏松性压缩骨折的效果，进而探讨治疗骨质疏松性压缩骨折时骨不愈合的最佳手术方式。方法2013年12月至2015年12月骨质疏松性压缩骨折骨不愈合的老年女性患者50例，分为两组，每组25例，A组采取PVP治疗，B组采取PKP治疗，分别对两组患者术前、术后VAS评分、骨水泥填充量及渗漏率、弥散方式进行比较。结果术前两组患者VAS评分差异无统计学意义（P>0.05），术后两组患者VAS评分均有显著性改善（P<0.05）；A组出现骨水泥渗漏11椎（44.0%），B组出现骨水泥渗漏4椎（16.0%），A组显著高于B组；手术后B组患者前缘椎体高度和恢复率均显著高于A组。行PVP的A组患者骨水泥以小腔空隙填充为主，行PKP的B组患者骨水泥主要以大腔填充为主。行PVP的A组患者骨水泥边缘呈球形，为均匀弥散方式，行PKP的B组患者骨水泥呈云雾状，为非均匀性弥散。结论对于骨质疏松性压缩骨折骨不愈合患者，无论是行PVP还是行PKP治疗，均能显著缓解患者的疼痛，PVP手术时间短，费用低，手术中的创伤较低，但骨水泥渗漏风险高，选择行PKP治疗更佳。%ObjectiveTo compared two types of inimally invasive surgery in the treatment of osteoporotic compression fractures, ie. percutaneous vertebral plasty(PVP)and protruding after percutaneous vertebral plasty(PKP)m,bone cement filling effect and dispersion method were evaluated,and then discussed the best operation way of the treatment of osteoporotic compression fractures bone.MethodsIn December 2013-December 2015,50 older women patients of osteoporotic compression fracture bone with not healing were selected,and divided into two groups,each group of 25 cases,Group A were treated with PVP,group B was treated with PKP. VAS score,bone cement filling quantity and leakage rate,dispersion methods of two groups of patients were compared.ResultsVAS score was no significant difference(P>0.05),postoperative VAS score were significantly improved in both groups(P<0.05);Group A, there were 11 vertebral bone cement leakage(44.0%)and group B 4 vertebral bone cement leakage(16.0%),the rate in group A was significantly higher than that of group B;Line PVP group A patients with bone cement was given priority to with small cavity gap filling,line PKP holds the B group of patients with bone cement are mainly composed of big cavity filling. Line PVP round the edge of a group of patients with bone cement,uniform dispersion method,line PKP holds cloud-like,B group of patients with bone cement for the heterogeneity of dispersion.Conclusion For patients with osteoporotic compression fracture with bone not-=heal,whether line PVP or PKP holds treatment,can significantly reduce the pain of patients,PVP has shorter operation time,low cost,the operation of trauma is low,but has a high risk of leakage of bone cement,while PKP has a better clinical effect.
展开▼
