密固达联合经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效研究

Clinical therapeutic effect of aclasta combined with percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture

目的探讨密固达(aclasta)联合经皮椎体成形术(PVP)对骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法从2015年6月~2016年10月选取我科住院经确诊为新鲜性OVCF的患者共90例,根据干预方法不同分为3组,试验组A组、对照组(B组、C组)。所有受试对象均行PVP,术后试验组进行密固达治疗,对照组进行安慰剂及密钙息治疗,分别使用Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)、骨密度变化和再发骨折率进行临床疗效评价,随访半年。结果所有受试对象术后ODI指数、VAS评分均较术前明显降低(P<0.01);术后3个月及半年,试验组ODI指数及VAS评分均持续下降(P<0.05),骨密度明显增加(P<0.01),再发骨折率明显低于对照组(B组、C组,P<0.01),且再发骨折经保守治疗疗效优于对照组;同时,B组再发骨折率明显高于C组(P<0.01)。结论 PVP可快速降低OVCF患者的疼痛及改善生活质量,但术后未进行密固达抗骨质疏松治疗的患者远期效果不理想;而密固达联合PVP是治疗OVCF的有效方法,值得临床广泛推广。

Objective To investigate the clinical therapeutic efficacy of percutaneous vertebral plasty(PVP)withAclasta on osteoporotic vertebral compression fractures(OVCF).Methods90patients with fresh OVCF cured indepartment of orthopedics of our hospital from June2015to October2016were selected and randomly divided intothree groups(experimental group-A,control group-B and control-C).The patients of group-A,group-B and group-Cwere treated with Aclasta,placebo and Miacalcic respectively.After operated by PVP,and the Oswestry functiondisability index(ODI),visual analogue scale(VAS),bone mineral density(BMD)and rate of prevalent fracture wererecorded and analyzed for the investigation of clinical therapeutic effects after PVP operation6months.ResultsThe ODI and VAS of all patients were decreased significantly after PVP(P<0.01).After PVP3and6months,ODI index and VAS score continued to decrease(P<0.05),BMD increased significantly(P<0.01),and the rate ofprevalent fracture significantly lower than the control groups(group-B,group-C,P<0.01),for the experimentalgroup.And the conservative curative effect of prevalent fracture of group-A was better than that of group B andgroup C.Meanwhile,the rate of prevalent fracture of group-B was significantly higher than the group-C(P<0.01).Conclusion PVP can rapidly reduce the pain and improve quality of life of OVCF patients,but the forward effect isnot ideal if without anti-osteoporosis treatment with aclasta.The PVP operation combined with aclasta is an effectivemethod for treating OVCF.It is deserved clinical promotion widely.