PVP和PKP治疗骨质疏松性椎体压缩骨折的护理

Nursing of PVP and PKP in the treatment of osteoporotic vertebral compression fractures

目的探讨经皮椎体成形术（PVP）和经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折的疗效和有效护理方法。方法选取自2004年12月至2010年12月在河北医科大学第三医院行椎体成形手术的156例骨质疏松性椎体压缩骨折患者，根据手术方式分为两组：PVP组（89例）和PKP组（67例），对两组患者的住院时间、住院费用、卧床时间、术后恢复时间、治疗前后疼痛视觉评分（VAS评分）、骨水泥渗漏率进行对比分析。结果PVP组患者住院时间为（4．85±0．81）d，卧床时间（1．48±0．68）d，术后恢复正常生活时间（2．36±0．84）d、治疗后VAS评分为（2．19±0．77）分；PKP组患者住院时间（4．71±0．77）d，卧床时间（1．53±0．52）d，术后恢复正常生活时间（2．40±0．64）d，治疗后VAS评分（2．26±0．63）分；两组在住院时间、卧床时间、术后恢复正常生活时间、治疗后VAS评分改善方面比较差异无统计学意义（t分别为0．702，0．355，0．491，0．348；P均〉0．05）。PVP组患者住院费用（1．30±0．19）万元，PKP组患者住院费用（4．79±0．22）万元，两组在住院费用比较差异有统计学意义（t=79．163，P〈0．01）。PVP、PKP两组患者在骨水泥渗漏率方面（30．34％VS13．43％）差异有统计学意义（x2=6．1531，P〈0．05）。结论PVP、PKP两种手术方式均能有效改善骨质疏松性椎体压缩骨折患者的疼痛症状，但在手术费用方面PVP较PKP低，在骨水泥渗漏率方面PKP较PVP低。

Objective To explore the effect and reasonable nursing methods of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） in the treatment of osteoporotic vertebral compression fractures. Methods Totally 156 patients with osteoperotic vertebral compression fractures were randomly selected in the third hospital of Hebei Medical University from December 2004 to December 2010. According to the surgical methods, all the patients were divided into two groups： PVP group （n =89） and PKP group （n =67）. The hospital stay, hospitalization costs, bed time, postoperative recovery time, VAS scores before and after treatment, cement leakage rate of beth PVP group and PKP group were analyzed. Results Group PVP： hospital stay （4.85 ± 0.81 ） d, bed time （ 1.48 ± 0.68） d, postoperative recovery time （2.36 ± 0. 84） d, VAS scores after treatment （2. 19±0.77）; Group PKP： hospital stay （4.71 ±0.77）d, bed time （1.53 ±0.52）d, postoperative recovery time （2.40 ± 0.64）d, VAS scores after treatment （2.26 ± 0.63 ）. There were no significant differences in the aspects of the hospital stay, bed time, postoperative recovery time, VAS scores after treatment between PVP group and PKP group （t =0. 702, 0. 355, 0. 491, 0. 348,respectively; P 〉0. 05）. Group PVP： hospitalization costs （ 1.30 ±0. 19） ten thousand yuan; Group PKP： hospitalization costs （4.79 ±0.22） ten thousand yuan,there was significant difference in the hospitalization costs（ t = 79. 163 ,P 〈 0. 01 ）. There was significant difference in the aspects of cement leakage rate between PVP group and PKP group （30.34% vs 13.43% ;x2 = 6. 153 1, P 〈 0. 05）. Conclusions Both PVP and PKP can effectively ease the pain in patients with osteoperotic vertebral compression fractures. Hospitalization costs is lower in PVP group than that in PKP group. However,cement leakage rate is higher.