经皮椎体后凸成形术在野战综合手术救治方舱中的应用

The application of field comprehensive operation rescue shelter in performing emergency percutaneous kyphoplasy at the disaster site

目的灾难救治现场,于野战综合手术救治方舱中对老年性骨质疏松性椎体压缩性骨折的受灾患者行经皮椎体后凸成形术(PKP)的近期临床疗效分析。方法回顾性分析2013年4月—2016年8月由该院参与救治的老年性骨质疏松性椎体压缩性骨折患者43例(51椎),患者伤后立即在该院研制的野战综合手术救治方舱中行PKP手术,观察患者平均手术时间,比较手术前后痛觉视觉模拟评分(VAS)的变化和侧位X线平片上相应节段Cobb角的变化及椎体前、中、后缘高度的变化。结果本组43例患者平均手术时间(52±15)min,术后VAS疼痛评分较术前明显降低(P<0.01),术后伤椎相应节段Cobb角较术前有显著改变(P<0.01),且伤椎椎体前、中缘高度较术前均由明显恢复(P<0.01),差异均有显著统计学意义。结论在野战综合手术救治方舱中对骨质疏松性压缩性骨折患者行PKP治疗是对老年患者紧急治疗的十分有效的方法,能早期解决患者骨折所导致的剧烈疼痛,改善患者预后。

Objective To analyze the short-term clinical efficacy of percutaneous kyphoplasy in treating aged patients with osteoporotic vertebral compression fractures in a field comprehensive operation rescue shelter at the disaster site. Methods The clinical data of 43 aged patients with osteoporotic vertebral compression fractures （51 diseased vertebrae in total）, who received treatment during the period from April 2013 to August 2016 in a field comprehensive operation rescue shelter at the disaster site, were retrnspectively analyzed. After injury, the patients were immediately sent to the field comprehensive operation rescue shelter, which was developed by aulhors＇ institute, to receive percutaneous kyphoplasy. The average operation time, preoperative and postoperative pain visual analogue scale （VAS） scores, the manifestations of Cobb＇ angle of the corresponding segment that was determined on lateral radiography, and the changes in anterior, middle and posterior height of the vertebrae were documented. Results The average operalion lime was （52.34±14.76） rain. The postoperative V AS scores were significantly decreased when compared to the preoperative ones （P〈0.01）. After pereutaneous kyphoplasy, the Cobb＇ angle of the corresponding segment of inju,＇ed vertebrae was obviously improved （P〈0.01）, moreover, the anterior, middle and posterior height of the injured vertebrae was remarkably restored （P〈0.01）. Conclusion In treating osteoporotic vertebral compression fractures in aged patienls, percutaneous kyphoplasy, thai is used as an emergency treatmenl and is carried out in a fielscomprehensive operation rescue shelter, is quite efleelive. This trealmenl can reliably relieve the severe pain caused by compression fraclure and improve the prognosis as well. （J Intervent Radiol, 2017, 26： 835-838）