PVP术后患者疼痛缓解与功能恢复的相关研究

Pain relief and functional recovery after percutaneous vertebroplasty

目的探讨经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折疼痛缓解和功能恢复的效果。方法回顾性分析自2015-01—2016-01采用PVP治疗的61例骨质疏松性椎体压缩骨折。记录术前1 d、术后1周、术后3个月、术后6个月、术后12个月的疼痛VAS评分和ODI指数,并计算术后各个时间点疼痛缓解及功能恢复的优良率。结果术后1周54例(88.5%)疼痛缓解良好,术后3个月疼痛缓解优良率达到100%。术后各时间点VAS评分均较术前明显降低,且术后3、6、12个月的VAS评分均较术后1周明显降低,差异有统计学意义(P<0.05);术后3、6、12个月VAS评分比较差异无统计学意义(P>0.05)。术后1周仅2例(3.3%)功能改善优良,术后3个月19例(31.1%)功能改善优良,术后6个月59例(96.7%)功能改善优良,术后12个月功能改善优良率达到100%。术后各时间点ODI指数均较术前明显降低,术后3、6、12个月ODI指数均较术后1周明显降低,且术后6、12个月ODI指数较术后3个月降低,差异有统计学意义(P<0.05);但术后12个月ODI指数与术后6个月比较差异无统计学意义(P>0.05)。结论 PVP是治疗骨质疏松性椎体压缩骨折的首选微创手术方法,效果良好。术后3个月患者疼痛症状可以迅速缓解,但是功能恢复理想却需要6个月时间,因此PVP术后康复锻炼应当引起足够重视。

Objective To explore the related factors of pain relief and functional recovery after percutaneous vertebroplasty in treatment of osteoporotic vertebral compression fractures. Methods From January 2015 to January 2016, a total of 61 patients eligible for inclusion criteria were enrolled in this retrospective study. VAS score and ODI index were recorded 1 day preoperatively, 1 week, and 3, 6, 12 months postoperatively, and the excellent and good rate of pain relief and functional recovery at different time points postoperatively were calculated. Results Fifty-four cases （88.5%） had good pain relief at l week after the operation, and the good rate of pain relief reached 100% after 3 months. VAS scores at different time points were significantly lower than those before operation, and the VAS scores at 3, 6 and 12 months after operation were significantly lower than those at 1 weeks after operation （P 〈0.05）. There was no significant difference in VAS score between 3 months, 6 months and 12 months after operation （P 〉0.05）. Only 2 cases （3.3%）/19 cases （31.1%） had excellent function improvement at 1 week, and 3 months postoperatively; however, 59 eases （96.7%）/61 cases （100%） at 6/12 months postoperatively. The ODI index at each time point was significantly lower than that before operation （P 〈0.05）, but there was no significant difference in ODI index between 12 months after operation and 6 months after operation （P 〉0.05）. Conclusion PVP is the first minimally invasive surgical treatment for osteoporotie vertebral compression fractures. The pain can be relieved rapidly 3 months after operation, but the ideal functional recovery takes 6 months. Therefore, rehabilitation exercises after PVP should be paid enough attention.