骨质疏松性椎体压缩骨折合并慢性阻塞性肺病治疗的回顾分析

A Retrospective Analysis of Osteoporosis Vertebral Compression Fracture Combined with Chronic Obstructive Pulmonary Disease

目的:探讨骨质疏松性椎体压缩骨折(Osteoporosis Vertebral Compression Fracture,OVCF)合并慢性阻塞性肺病(Chronic Obstructive Pulmonary Disease,COPD)的特点及治疗方法。方法:回顾分析OVCF合并COPD病例50例,共76椎,将获得随访的47例分为经皮椎体成形术(Percutaneous Vertebroplasy,PVP)组及保守治疗组,比较两组治疗前、治疗1周、1月、3月VAS,ODI评分。结果:50例患者平均年龄76.52岁,男性28例,女性22例;病因:咳嗽17例,占34%,扭伤3例,占6%,跌伤10例,占20%,无明显诱因20例,占40%;伤椎:单椎体33例,占66%,两椎体及以上17例,占34%,其中有3例患者出现4次再骨折,1例患者出现2次再骨折,其中3例因肺部感染、呼吸衰竭而死亡,占6%,余下的47例中PVP组14例,保守治疗组33例。治疗前两组VAS、ODI评分差异无统计学意义;治疗1周、1月、3月VAS、ODI评分差异具有统计学意义,PVP组优于保守治疗组。结论:OVCF合并COPD易出现多节段骨折,再骨折发生率高,考虑可能与骨密度低有关,咳嗽是COPD诱发OVCF的重要因素,如无手术禁忌,建议尽早手术。

Objective：To summarize the characteristics and treatment of osteoporotic vertebral compression fractures（OVCF）combined with chronic obstructive pulmonary disease（COPD）.Methods：50cases of osteoporotic vertebral compression fractures with COPD cases were analyzed retrospectively,a total of 76 vertebrae.47patients were divided into PVP group and conservative treatment group.VAS and ODI scores of the two groups were compared before treatment,1week,1month,and 3months after treatment.Results：50patients with an average age of 76.52 years,male 28 cases,female22cases.Cough in 17 cases,accounting for 34%,and 3cases of sprain,accounted for 6%,Injuries in 10 cases,accounting for 20%,no obvious cause in 20 cases,and accounting for 40%.Single vertebra in 33 cases,accounted for 66%,two vertebrae and above 17,accounted for 34%.3patients suffered from re fracture 4times and patient re fracture 2times.3cases died due to pulmonary infection,respiratory failure,accounting for 6%.Among the remaining 47 cases,14were in the PVP group and 33 cases in the conservative treatment group.There was no significant difference in VAS and ODI scores between the two groups before treatment.1week,1month and 3months after treatment,VAS and ODI score was statistically significant difference between the two groups,PVP group is better than the conservative treatment group.Conclusion：Cough is an important factor in COPD induced OVCF.If there is no surgical contraindication,it is recommended to operate as early as possible.