经皮球囊扩张椎体成形术手术时机对骨质疏松性椎体压缩骨折患者临床疗效的影响

Study on the Influences of PKP Timing on Clinical Curative Effect for OVCF Patients

目的:探讨经皮球囊扩张椎体成形术(PKP)手术时机对骨质疏松性椎体压缩骨折(OVCF)患者临床疗效的影响。方法:选择2018年1月至2018年12月本院骨科收治的92例OVCF患者,根据患者骨折至PKP手术时间分为观察组(骨折2周内行PKP,48例)和对照组(骨折2周以上行PKP,44例)。记录手术时间、手术前后视觉模拟量表(VAS)评分、受伤椎体Cobb角及椎体前缘高度变化情况,统计两组骨水泥注射量及术后骨水泥渗漏发生例数。于术前及术后2个月随访时,采用Oswestry功能障碍指数(ODI)及生活质量量表(SF-36)评估患者功能障碍程度及生活质量。结果:两组患者在手术时间、术后Cobb角、骨水泥注射量及术后骨水泥渗漏率方面未见明显差异(t=0.627,P=0.532;t=1.888,P=0.062;t=1.141,P=0.257;χ~2=0.046,P=0.831),但观察组术后VAS评分明显低于对照组(t=2.079,P=0.040),椎体前缘高度明显高于对照组(t=4.082,P<0.001),且观察组术后随访时的ODI评分明显低于对照组(t=4.820,P<0.001),SF-36评分明显高于对照组(t=9.339,P<0.001)。结论:早期手术未明显增加手术时间、骨水泥注射量及术后骨水泥渗漏率,且有利于减轻患者术后疼痛程度,缓解功能障碍,提升生活质量。

Objective:To explore influences of percutaneous balloon kyphoplasty(PKP)timing on clinical curative effect of patients with osteoporotic vertebral compression fractures(OVCF).Methods:92 OVCF patients from orthopedics department of the hospital from January 2018 to December 2018 were enrolled.According to time from fracture to PKP,they were divided into observation group(PKP within 2 weeks after fracture,48 cases)and control group(PKP at above 2 weeks after fracture,44 cases).The operation time,changes in scores of visual analog scale(VAS),injured vertebral Cobb angle and anterior vertebral height before and after surgery were compared.The injection volume of bone cement and number of cases with postoperative bone cement leakage in both groups were statistically analyzed.Before and at 2 months after surgery,Oswestry dysfunction index(ODI)and short form 36 health survey(SF-36)were applied to assess dysfunction degree and quality of life.Results:There was no significant difference between the two groups in operation time,postoperative Cobb angle,injection volume of bone cement or postoperative leakage rate of bone cement(t=0.627,P=0.532;t=1.888,P=0.062;t=1.141,P=0.257;χ~2=0.046,P=0.831).The postoperative VAS score of observation group was significantly lower than that of control group(t=2.079,P=0.040),while anterior vertebral height was significantly higher than that of control group(t=4.082,P<0.001).At postoperative follow-up,ODI score of observation group was significantly lower than that of control group(t=4.820,P<0.001),while quality of life score was significantly higher than that of control group(t=9.339,P<0.001).Conclusion:Early surgery does not significantly increase operation time,injection volume of bone cement or postoperative leakage rate of bone cement,which is beneficial to alleviate postoperative pain,relieve dysfunction,and improve quality of life.