PKP治疗绝经后妇女骨质疏松性椎体隐匿性骨折的临床疗效观察

Efficacy of Percutaneous Kyphoplasty in Treating Occult Osteoporotic Vertebra Fracture of Postmenopausal Women

目的探讨经皮球囊扩张椎体成形术(PKP)治疗绝经后骨质疏松性椎体隐匿性骨折的疗效。方法选取绝经后骨质疏松性椎体隐匿性骨折患者35例(共52节),随机分为两组,观察组19例(30节)给予PKP治疗,对照组16例(22节)给予保守治疗。术后应用视觉模拟评分法进行疼痛缓解程度评估,用日常生活自理能力量表对治疗后患者的生活质量进行评估,同时观察术后伤椎椎体形态学变化,上述指标均分别在术后1周、3个月、6个月、12个月进行评价。结果观察组30节椎体穿刺全部成功,无椎管内渗漏、肺栓塞等并发症发生。治疗后1周、3个月、6个月观察组患者的疼痛缓解率及生活质量评分与对照组比较,差异均有统计学意义(P<0.01),治疗后12个月时两组上述两项指标比较,差异无统计学意义(P>0.05)。治疗后1周、3个月、6个月两组患者椎体前缘、中央、后缘丢失高度比较,差异无统计学意义(P>0.05),但治疗后12个月时对照组患者椎体明显塌陷,椎体丢失高度显著高于观察组,差异有统计学意义(P<0.05)。结论 PKP治疗绝经期后妇女骨质疏松性椎体隐匿性骨折与传统保守治疗相比,可迅速缓解疼痛,明显改善患者的生活质量,并可显著预防椎体进一步塌陷,防止脊椎后凸畸形发生。

Objective To explore the efficacy of percutaneous kyphoplasty （PKP） in treating occult osteoporotic verte- bra fracture of postmenopausal women. Methods A total of 35 cases （52 vertebrae） of occult osteoporotic vertebra fracture of postmenopausal women were randomly divided into the observation group （19 cases, 30 vertebrae） and the control group （16 eases, 22 vertebrae） . The observation group were treated by PKP and the control group were treated by conservative thera- py. Degrees of pain alleviation were evaluated via Visual Analogue Scale （VAS） and life quality was evaluated via Activity of Dai- ly Living Scale （ADL） postoperatively at 1 week, 3 months, 6 months, and 12 months after the operation respectively, with the morphological changes of the vertebrae observed at the same time. Results Puncture was successfully performed in all cases of the observation group, with no serious complications noted. Pain alleviation rates and ADL scores were significantly different be- tween the two groups at 1 week, 3 months, and 6 months after the operation （P 〈0.01 ） . No such differences were noted at 12 months after treatment （P 〉 0. 05 ） . The heights of the vertebral body showed no significant difference at I week, 3 months, and 6 months （ P 〉 0. 05 ） but turned significantly different （ with the observation group higher than the control group） at 12 months of follow - up （ P 〈 0. 05） . Conclusion PKP is an effective and safe procedure for treating occult osteoporotie vertebra fracture of postmenopausal women. PKP shows satisfying antalgic effects and improves quality of life of the patients. PKP can also effectively prevent the collapse and deformation of the vertebrae.