老龄椎体压缩性骨折介入与保守治疗生活质量对照研究

The quality of life in the aged patients with vertebral compression fractures receiving interventional therapy or receiving conservative treatment:a comparative study

目的比较经皮椎体成形术(PVP)和保守治疗老龄椎体压缩性骨折的临床疗效,分析影响患者生活质量的因素,探讨不同的治疗方法对患者生活质量的影响差异。方法收集85例老龄骨质疏松性脊柱骨折病例,保守治疗42例,经PVP 43例,采用视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、世界卫生组织生活质量量表(WHOQOL-BREF),综合统计比较治疗前后上述指标在数据上的差异变化。结果本研究中介入治疗组,VAS术前评分为7.9±0.97,术后1、3和6个月分别为2.91±0.87、2.18±0.63、1.53±0.70。ODI术前评分96.14±4.69,术后1、3和6个月分别为45.19±29.12、16.63±14.87、5.73±5.55。WHOQOL-BREF术前评分52.07±3.36,术后1,3和6个月分别为64.21±2.27、75.56±2.98、87.21±3.00。保守治疗组急性期和术后1,3和6个月VAS评分分别为8.0±0.62、6.0±0.77、3.0±0.83、2.19±0.63。ODI评分分别为97.52±3.50、84.12±10.73、49.26±24.93、15.21±10.94。WHOQOL-BREF评分分别为55.5±3.03、63.05±1.92、69.26±2.94、77.31±5.39。结论生理情况、心理情况、社会、环境是影响生活质量的重要因素。PVP比保守治疗老龄椎体压缩性骨折患者在生理、心理、社会方面获益明显。

Objective To compare the clinical efficacy of percutaneous vertebroplasty(PVP)with that of conservative therapy in treating osteoporotic vertebral compression fractures in the aged patients,to analyze the factors affecting the quality of life of patients,and to explore the effect of different treatment methods on the quality of life of patients.Methods A total of 85 aged patients with osteoporotic spinal fractures were collected.The patients were divided into conservative group(n=42)and PVP group(n=43).The preoperative and postoperative visual analog scale(VAS)scores,Oswestry dysfunction indexes and World Health Organization Quality of Life Scale(WHOQOL-BREF)scores were recorded and were used to make a comprehensive evaluation of their changes.Results In PVP group,the preoperative VAS score was(7.9±0.97),the one-month,3-month and 6-month postoperative VAS scores were(2.91±0.87),(2.18±0.63)and(1.53±0.70)respectively.The preoperative ODI score was(96.14±4.69),the one-month,3-month and 6-month postoperative ODI scores were(45.19±29.12),(16.63±14.87)and(5.73±5.55)respectively.The preoperative WHOQOL-BREF score was(52.07±3.36),the one-month,3-month and 6-month postoperative scores were(64.21±2.27),(75.56±2.98)and(87.21±3.00)respectively.In the conservative group,the acute-stage,one-month,3-month and 6-month VAS scores were(8.0±0.62),(6.0±0.77),(3.0±0.83)and(2.19±0.63)respectively.The ODI scores were(97.52±3.50),(84.12±10.73),(49.26±24.93)and(15.21±10.94)respectively.The WHOQOL-BREF scores were(55.5±3.03),(63.05±1.92),(69.26±2.94)and(77.31±5.39)respectively.Conclusion The physiological,psychological,social and environmental conditions are important factors that can affect the quality of life.In treating osteoporotic vertebral compression fractures in aged patients,when compared with conservative treatment,PVP can allow the patient to gain more benefits in the physiological,psychological,and social aspects.