椎体后凸成形术后患者的肺功能变化及相关分析

Changes of Pulmonary Function and Correlated Analysis for Older Women Suffered from Osteoporotic Vertebral Compression Fractures after Kyphoplasty

目的 前瞻性研究运用椎体后凸成形术治疗骨质疏松性胸腰段脊柱压缩骨折后患者肺功能的改善情况,并探究其相关因素。方法 选行椎体后凸成形术的老年女性骨质疏松性胸腰段脊柱压缩骨折患者15例作为研究对象,测量胸椎后凸角,肺功能(VC、IC、RV、FRC、TLC、FVC、MVV)、局部后凸角、VAS评分,并于术后3d、1月时分别再次测量以上指标。统计分析患者术前、术后3d、术后1月时肺功能的变化及相关因素。结果 椎体后凸成形术后3d患者FVC、MVV显著提高,椎体前、中、后缘高度恢复,骨折椎体局部后凸角明显改善,VAS评分降低。术后1月时MVV进一步提高,而其它肺功能指标无明显变化。统计显示胸椎后凸角与VC、IC呈显著负相关。局部后凸角与所有肺功能指标均无显著相关性。术后3d时患者VAS评分的降低值与FVC、MVV提高的百分率存在明显正相关。结论 老年女性骨质疏松性胸腰段脊柱压缩骨折椎体后凸成形术后3d患者疼痛显著缓解,脊柱矢状面排列改善,同时FVC、MVV亦有提高,这种提高与疼痛缓解有明显正相关。术后1月时,患者疗效巩固,且MVV进一步提高。

Objective To explore the changes of pulmonary function of the older women who suffered from osteoprotic vertebral compression fractures in thoracolumbar segment after kyphoplasty. Meanwhile The possible related factors of the changes were found by statistical means. Methods Fifteen older women with osteoporotic vertebral compression fractures in thoracolumbar segment had been performed by kyphoplasty from October 2002. Thoracic kyphotic angle, local kyphotic angle, pain scores and pulmonary function were measured for all patients, VC, IC, RV, FRC, TLC, FVC and MVV were selected as the parametes of pulmonary function. Three days and one month later after the procedure, all parametes were re-measured. SPSS11.5 statistic software was used to analysis the changes of the lung function and the associated factors. Results The height of vertebral body was restored, local kyphotic angle was improved and pain scores were decreased obviously after kyphoplasty. FVC and MVV were increased significantly three days after the procedures, while only MVV had been gone on to improve one month later. There is a significant negative correlation between thoracic kyphotic angle and VC and IC. Local kyphotic angle has no correlation with pulmonary functional parametes. The value of the decrease of pain scores has remarkably correlated with the percent of the improvement of FVC and MVV measured three days after kyphoplasty positively. Conclusion Kypho- plasty can significantly release pain, as well as improve sagittal alignment for old women suffered from osteoporotic vertebral compression fractures in thoracolumbar segment. Meanwhile FVC and MVV are improved, the improvement of the percent of which has positive correlation with the decrease of pain scores three days after kyphoplasty. One month later, the results of kyphoplasty are stable and MVV goes on to improve.