阿法骨化醇治疗皮穿刺椎体后凸成形术术后残余痛的效果

Effect of Alfacalcidol in treating postoperative residual pian of percutanous kyphoplasty

目的探讨阿法骨化醇治疗皮穿刺椎体后凸成形术(PKP)术后残余痛及增加骨密度的效果。方法回顾性分析中国石油天然气集团公司中心医院2013年1~12月采用PKP治疗骨质疏松性椎体压缩骨折62患者的临床资料。观察组(32例)采用阿法骨化醇+碳酸钙D3治疗;对照组(34例)采用碳酸钙D3治疗。记录术后1 d、各次随访时的VAS评分,术前、随访时腰椎及右股骨颈骨密度值。记录骨水泥渗漏、手术并发症、新发骨折、药物副作用的病例。随访时监测患者血钙、磷,肝肾功能等化验指标。结果所有患者均完成随访,随访平均时间为(15.5±0.6)个月,随访时未出现药物副作用,血钙、磷代谢紊乱及肝肾功能指标异常。两组术后1 d VAS评分差异无统计学意义(P>0.05);术后6、12个月观察组VAS评分低于对照组,差异有统计学意义(P<0.05);两组术后12个月VAS评论低于术后6个月,差异有统计学意义(P<0.05)。两组间术前骨密度值比较差异无统计学意义(P>0.05);术后6、12个月随访时观察组骨密度值高于对照组,差异有统计学意义(P<0.05)。结论阿法骨化醇联合钙剂可显著提高患者骨密度,有效缓解PKP术后骨质疏松性残余痛,且长期服用不良反应小,安全性高。

Objective To discuss the effect of Alfacalcidol in treating postoperative residual pian of percutanous kypho- plasty （PKP） and increasing bone mineral density（BMD）. Methods From January to December 2013, in CNPC Central Hospital, the clinical data of 62 patients with osteoporotic vertebral compression fractures underwent PKP were retro- spectively analyzed. Observation group （32 cases） was given Alfacalcidol ＋ calcium carbonate D3, control group （34 cases） was given calcium carbonate D3. VAS after operation 1 d and each follow-up, BMD of lumbar vertebra and right femoral neck before operation and each follow-up were recorded, the cases of bone cement leakage, operative compli- cations, new osteoporotic vertebral compression fractures and side effect of drug were recorded, calcium, phosphorus of blood, hepatic and renal function were examined at each follow-up. Results ALL patients were followed up, mean time was （15.5±0.6） months. There was no side effect of drug case, metabolism disorders of calcium-phosphate, hepatic and renal dysfunction during follow-up. The VAS of two groups before operation 1 d were compared, the difference was not statistically significant （P 〉 0.05）; after operation 6, 12 months, VAS of observation group were lower than those of con- trol group, the differences were statistically significant （P 〈 0.05）; VAS of two groups after operation 12 months were lower than those after operation 6 months, the differences were statistically significant （P 〈 0.05）. The BMD of two groups before operation were compared, the difference was not statistically significant （P 〉 0.05）; after operation 6, 12 months, BMD of observation group were higher than those of control group, the differences were statistically significant （P 〈 0.05）. Conclusion Alfacalcidol comboination cal- cium can significantly increase BMD and ease postoper- ative residual pian of .PKP, and its long-term adverse reaction is small, and which is very safe.