经皮椎体球囊扩张成形术治疗AO-A型胸腰椎骨折的效果

Effect of percutaneous kyphoplasty in the treatment of AO-A thoracolumbar fractures

目的观察经皮椎体球囊扩张成形术(PKP)治疗AO-A型胸腰椎骨折患者的临床效果。方法选择2018年1月至2020年12月江苏省昆山市中医医院收治的260例AO-A型胸腰椎骨折患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组130例。对照组采用Wiltse入路切开复位椎弓根钉内固定术治疗,观察组采用PKP治疗。记录患者手术创伤及出血情况、住院时间、视觉模拟评分法(VAS),记录两组患者术后并发症发生情况。评价术后两组伤椎前缘高度、后凸Cobb角变化及生活功能恢复情况。结果两组术后伤椎前缘高度高于术前,后凸Cobb角和Oswestry功能障碍指数问卷表(ODI)评分低于术前,差异均有统计学意义(P<0.05)。观察组术后ODI评分低于对照组,差异有统计学意义(P<0.05)。观察组术后3、7 d时VAS评分低于术前,术后7 d时VAS评分低于术后3 d时,差异有统计学意义(P<0.05),对照组术后1 d时VAS评分高于术前,术后7 d时VAS评分低于术后3 d时及术前;观察组术后1、3及7 d时VAS评分低于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论PKP治疗AO-A型胸腰椎骨折患者效果显著,有助于减轻术后疼痛,促进患者早期康复。

Objective To observe the clinical effect of percutaneous kyphoplasty(PKP)in the treatment of AO-A thoracolumbar fractures.Methods A total of 260 patients with AO-A thoracolumbar fractures who were admitted in Kunshan Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were selected as the the research objects.They were divided into observation group and control group by random number table method,with 130 cases in each group.The control group was treated with Wiltse incision and reduction,the observation group was treated with PKP.The surgical trauma and hemorrhage,hospitalization time,and visual analog scale(VAS)were recorded,the complications of the two groups after operation were recorded.The height of the anterior border of the injured group,the change of the kyphosis Cobb angle,and the recovery of life function were compared between the two groups.Results The anterior height of the injured vertebrae in the two groups was higher than that before surgery,and the kyphosis Cobb Angle and Oswestry dysfunction index(ODI)score were lower than that before surgery,the differences were statistically significant(P<0.05).The ODI score of the observation group was lower than that of the control group after operation,and the difference was statistically significant(P<0.05).The VAS score of the observation group at three and seven days after surgery was lower than that before surgery,and at seven days after surgery was lower than that at three days after surgery,the differences were statistically significant(P<0.05),the VAS score of the control group at one day after surgery was higher than that before surgery,and at seven days after surgery was lower than that at three days after surgery and before surgery.VAS scores of the observation group at one,three and seven days after surgery were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The PKP is effective in the treatment of Ao-a thoracolumbar fractures,which helps to reduce postoperative pain and promote early rehabilitation.