不同黏度骨水泥在老年骨质疏松性胸腰椎骨折PKP治疗中的疗效分析

Efficacy of Different Viscosity Bone Cement in the Treatment of Senile Osteoporotic Thoracolumbar Fracture with Percutaneous Kyphoplasty

【目的】探讨不同黏度骨水泥在老年骨质疏松性胸腰椎骨折经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）中的疗效分析。【方法】对100例骨质疏松性胸腰椎骨折老年患者进行不同黏度骨水泥PKP治疗，根据骨水泥黏度分为两组，高黏度骨水泥68例（观察组），低黏度骨水泥32倒（对照组）。比较两组患者伤椎椎体术前术后平均高度、视觉模拟评分法（VAS）评分及骨水泥渗漏、术后并发症情况。【结果】观察组有效率为98．5％（67／68），显著高于对照组93．8％（30／32）；两组患者术前VAs评分比较差异无统计学意义（P〉0．05），术后随着时间延长两组患者VAS评分依次减少（P〈0．05），但观察组减少更明显（P〈0．05）；观察组术前椎体平均高度为（19．67±1．60）mm，与对照组（19．59±2．20）mm比较差异无统计学意义（P〉0．05）；观察组、对照组术后椎体平均高度分别为（23．66±2．80）mm、（20．11±3．20）mm，均明显高于同组术前（P〈0．05），且观察组明显高于对照组（P〈0．05）。观察组术后渗漏率为5．9％（4／68），明显低于对照组12．5％（4／32）；观察组并发症发生率为2．9％（2／68），明显低于12．5％（4／32），其差异均有统计学意义（P〈0．05）。【结论】高黏度骨水泥PKP术治疗老年骨质疏松性胸腰椎骨折患者疗效满意，水泥渗漏率少，并发症发生率低。值得临床推广应用。

[Objective]To explore the method of percutaneous kyphoplasty （PKP） in the treatment of senile osteoporotic thoraco- lumbar fractures with bone cement of different viscosity. [Methods]One hundred cases of elderly patients with osteoporotic thoracolum- bar fractures were treated using PKP with bone cements of different viscosity. According to the viscosity of the bone cement,the 100 cases were divided into two groups, an observation group（68 cases）with high viscosity and the control group （32 cases）with low viscosity bone cement. The Visual Analog Score （VAS）, the average height of injured centrum, bone cement leakage situation, and complications were detected and compared between patients of both groups pre-operation and post-operation. [Results]The effective rate of the observation group was 98.5% （67/68）, which was significantly higher than that of the control group, 93.8% （30/32）.There was no statistically significant difference between the VAS scores of the two groups at pre-operation （ P 〉0.05）. At post-operation, VAS scores of both groups were lower; the differences were statistically significant （ P 〈0.05）.And the VAS score of the observation group lowered significantly more than the VAS score of the control group （ P 〈0.05）.The pre-operation average heights of injured centrum in the observation group and control group were （19.67± 1.60）mm and （19.59±2.20）mm, respectively. The difference between these heights was not statistically significant （ P 〉0,05）. The average heights of injured centrum post-operation in the observation and con t rol groups were （ 23.66 ± 2.80） mm and （ 20.11±3.20 ） mmm, respectively. The differences between average heights post- and pre-operation in both groups were statistically significant （ P 〈0.05）. Furthermore, the difference between the average heights was significantly more in the observation group （ P 〈0.05）.The occurrence of bone cement leakage was 5.9% （4/68） in the observation group, Which was significantly lower than the occurrence in the control group, 12.5% （4/32）. The occurrence of complications in the observa- tion group was 2.9 （2/68）, which was significantly lower than the occurrence in the control group, 12.5% （4/32） ; the difference was statistically significant （ P 〈0.05）. [Conclusion] PKP with bone cement of high viscosity has a satisfactory curative effect on senile pa- tients with osteoporotic thoracolumbar fractures; it is safer and more effective.