球囊扩张椎体成形术治疗老年新鲜椎体压缩性骨折疗效分析

Effect of percutaneous kyphoplasty for senile patients with fresh vertebral compression fracture

目的探讨球囊扩张椎体成形术(PKP)治疗老年新鲜椎体压缩性骨折对患者生存质量及视觉模拟评分法(VAS)评分的影响。方法将2013年7月至2016年2月我院收治的136例老年新鲜椎体压缩性骨折患者按抽签法分为观察组(n=68)与对照组(n=68)。对照组行经皮椎体成形术(PVP)治疗,观察组行PKP治疗,比较2组患者术前、术后15周及1年时Cobb角、患椎前缘高度、生存质量、VAS评分、及Barthel指数评定量表(BI)评分的变化情况,同时比较2组并发症发生情况。结果术后15周及1年,对照组Cobb角、患椎前缘高度较术前差异无统计学意义(P>0.05),观察组Cobb角明显低于术前与对照组同期,患椎前缘高度明显高于术前与对照组同期,差异均具有统计学意义(P<0.05);术后15周及1年,2组患者VAS评分明显低于术前,BI评分明显高于术前,差异具有统计学意义(P<0.05),2组患者VAS评分、BI评分差异无统计学意义(P>0.05);观察组并发症总发生率为1.47%,较对照组11.76%更低,2组比较差异具有统计学意义(P<0.05);术后15周及1年,2组各项生活质量评分明显高于术前,差异均具有统计学意义(P<0.05),2组各项生活质量评分差异无统计学意义(P>0.05)。结论 PKP治疗老年新鲜椎体压缩性骨折可有效提升患者生存质量与生活能力,降低VAS评分,同时有效纠正椎体畸形及患椎前缘高度,安全性较高。

Objective To investigate the effect of percutaneous kyphoplasty（ PKP） on survival quality and visual analogue scale（ VAS）in senile patients with fresh vertebral compression fracture（ VCF）. Methods Totally 136 senile patients with fresh VCF treated in our hospital from July 2013 to February 2016 were selected and divided into the observation group（ n = 68） and the control group（ n = 68） by draw lots. The control group was given percutaneous vertebroplasty（ PVP）,while the observation group was treated with PKP. The changes in Cobb angle,anterior vertebral height,survival quality,VAS score,Barthel index（ BI） before and after operation for 15 weeks and 1 year,and complications were compared between the two groups. Results After operation for 15 weeks and 1 year,the Cobb angle and anterior vertebral height in the control group were compared with those before operation and there was no statistical significance（ P〉 0. 05）. The Cobb angle in the observation group was lower than that before operation in the same period with the control group,and the anterior vertebral height in the observation group was significantly higher than that before operation in the same period with the control group and the difference was statistically significant（ P〈 0. 05）. After operation for 15 weeks and 1 year,the VAS scores of two groups were significantly lower than those before operation,BI score was significantly higher than that before operation and the difference was statistically significant（ P 〈0. 05）,and there was no statistical significance in VAS and BI scores between the two groups（ P〉 0. 05）. The total incidence of complications in the observation group was 1. 47%,which was lower than 11. 76% in the control group,and the difference was statistically significant（ P〈 0. 05）. After operation for 15 weeks and 1 year,the scores of survival quality in the two groups were higher than those before operation,and there was statistical significance（ P 〈0. 05） and compared between the two groups the scores of survival quality were of no statistical significance（ P〉 0. 05）. Conclusion PKP in treatment of senile fresh VCF can increase survival quality and living ability,decrease VAS score and correct vertebral abnormality and anterior vertebral height,which shows higher safety.