三种方法治疗老年椎体压缩性骨折术后骨密度的变化

Effects of Three Different Treatments on Bone Mineral Density in Elderly Patients with Vertebral Compression Fracture

目的对比分析不同方法治疗中老年椎体压缩性骨折(VCF)骨密度改善情况。方法选择我院就诊的年龄为50~65岁的74例中老年VCF患者并按意愿分为三组,分别为保守治疗(保守组,23例)、椎体成形术治疗(PVP组,24例)及球囊扩张椎体后凸成形术治疗(PKP组,27例)。对治疗后三组患者疼痛程度、治疗前和治疗后3、6、9和12个月椎体骨密度进行分析。结果三组患者治疗后疼痛程度间差异有统计学意义(P<0.05),且PKP组无痛比例多于保守组(P<0.05)。治疗后3、6、9个月时三组患者骨密度差异均有统计学意义(P均<0.05),治疗后3、6、9个月,PVP组和PKP组患者骨密度均高于保守组(P均<0.05),保守组患者治疗后3、6、9个月时骨密度值均低于治疗前(P均<0.05)。结论PVP和PKP对VCF均有一定治疗效果,能减少骨量丢失,PKP可缓解患者治疗后疼痛。

Objective To compare and analyze the improvement of bone mineral density in the treatment of vertebral compression fracture(VCF)in the elderly by different methods.Methods Total 74 middle-aged and elderly patients with VCF aged 50-65 were selected and divided into three groups according to their wishes:conservative treatment(conservative group,23 cases),vertebroplasty(PVP group,24 cases)and balloon kyphoplasty(PKP group,27 cases).The degree of pain,vertebral bone mineral density(BMD)before and 3,6,9 and 12 months after treatment in the three groups were analyzed.Results The painlessness between the three groups was statistically significant(P<0.05),and the perentace of painlessness in the PKP group was significantly higher than that in the conservative group(P<0.05).There were significant differences in bone mineral density between the three groups at 3,6,and 9 months after treatment(P all<0.05).At 3,6,and 9 months after treatment,the bone mineral density of the PVP group and the PKP group were higher than those of the conservative group(P all<0.05).Conclusion PVP and PKP have obvious effects on VCF treatment,which can effectively reduce bone loss,especially PKP can significantly relieve post-treatment pain.