PKP和PVP治疗老年骨质疏松性椎体压缩性骨折的对比评估

Comparative Evaluation of PKP and PVP in the Treatment of Senile Osteoporotic Vertebral Compression Fractures

目的对比老年骨质疏松性椎体压缩性骨折(OVCF)治疗中椎体后凸成形术(PKP)、椎体成形术(PVP)的临床效果。方法于2018年2月—2019年12月便利选取该院收治的老年OVCF折患者48例,平均分为两组治疗,I组用PVP术式,Ⅱ组PKP用术式,对比两组治疗结局。结果Ⅰ、Ⅱ组骨水泥用量:(3.25±1.01)、(3.26±1.02)mL,差异无统计学意义(t=0.034,P=0.486);Ⅰ、Ⅱ组住院天数:(10.56±1.20)、(10.58±1.21)d,差异无统计学意义(t=0.057,P=0.477);Ⅰ、Ⅱ组手术时间:(36.25±4.58)、(46.50±3.45)min,Ⅱ组用时较长,差异有统计学意义(t=8.757,P<0.05);Ⅰ、Ⅱ组透视次数:(16.20±2.30)次、(20.50±3.50)次,Ⅱ组次数较多,差异有统计学意义(t=5.030,P<0.05)。术前I组、Ⅱ组VAS评分差异无统计学意义(t=0.026,P>0.05),术后2周Ⅱ组VAS评分显著降低,差异有统计学意义(t=8.289,P<0.05),椎体恢复高度两组相比,Ⅱ组恢复更好,差异有统计学意义(t=6.174,P<0.05)Ⅱ并发症总发生率为4.17%,Ⅰ组为33.33%,组间差异有统计学意义(χ^(2)=4.923,P<0.05)。结论PKP、PVP两种术法均能有效治疗老年OVCF,PKP手术用时及透视次数较多,但PKP术后患者疼痛感较低,椎体恢复良好且并发症较少。

Objective To compare the clinical effects of kyphoplasty(PKP)and vertebroplasty(PVP)for elderly osteoporotic vertebral compression fractures(OVCF).Methods 48 elderly patients with OVCF fracture in the hospital from February 2018 to December 2019 were convenient selected and divided into two groups for treatment.Group I was treated with PVP and group II was treated with PKP.The treatment outcomes of the two groups were compared.Results The amount of bone cement in groupⅠandⅡ:(3.25±1.01)mL,(3.26±1.02)mL,the difference was not statistically significant(t=0.034,P=0.486);the length of stay in groupⅠandⅡ:(10.56±1.20)d,(10.58±1.21)d,the difference was not statistically significant(t=0.057,P=0.477);operation time in group I and II:(36.25±4.58)min,(46.50±3.45)min,and it took longer in groupⅡ,the difference was statistically significant(t=8.757,P<0.05);The number of fluoroscopy in group I and II:(16.20±2.30)times,(20.50±3.50)times,the number of times in groupⅡwas more,the difference was statistically significant(t=5.030,P<0.05).There was not statistically significant difference in VAS scores between group I and groupⅡbefore operation(t=0.026,P>0.05),and the VAS score of groupⅡwas significantly lower 2 weeks after operation,the difference was statistically significant(t=8.289,P<0.05);height of vertebral body recovery was compared between the two groups was better in groupⅡ,the difference was statistically significant(t=6.174,P<0.05);total incidence of complications was 4.17%in the groupⅡand 29.17%in group.There was statistically significant difference between the two groups(χ^(2)=4.923,P<0.05).Conclusion Both PKP and PVP can effectively treat elderly OVCF.PKP surgery takes more time and the number of fluoroscopy,but patients after PKP have lower pain,good vertebral recovery and fewer complications.