中医传统手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩性骨折临床价值

Clinical Value of Traditional Chinese Medicine Sleight Reduction Combined with Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

目的:研究中医传统手法复位联合经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床价值。方法:选取常德市第一中医医院2018年7月至2019年12月期间收治的82例骨质疏松性椎体压缩性骨折患者,按照奇偶数分组法分为对照组与观察组,各41例。对照组实施经皮椎体成形术治疗,观察组实施中医传统手法复位联合经皮椎体成形术治疗。将两组的治疗效果及不良反应发生情况进行比较。结果:术后7 d观察组患者的疼痛数字评分法(NRS)评分低于对照组,差异具有统计学意义(P<0.05)。术后6个月两组患者的脊柱后凸Cobb角均有不同程度减少,伤椎椎体前缘高度均有不同程度提高,且观察组的脊柱后凸Cobb角小于对照组,伤椎椎体前缘高度高于对照组,差异具有统计学意义(P<0.05)。术后6个月观察组患者的Oswestry功能障碍指数(ODI)评分低于对照组,差异具有统计学意义(P<0.05)。观察组患者不良反应发生率为4.88 %,低于对照组的12.20 %,差异具有统计学意义(P<0.05)。观察组患者的单个椎体手术时间、术中透视时间、住院费用均低于对照组,差异具有统计学意义(P<0.05)。观察组患者的骨水泥弥散系数与对照组比较,差异无统计学意义(P>0.05)。结论:对骨质疏松性椎体压缩性骨折患者实施中医传统手法复位联合经皮椎体成形术治疗安全有效。

Objective To study the clinical value of traditional Chinese medicine sleight reduction combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture.Methods 82 patients with osteoporotic vertebral compression fracture treated in Changde First Hospital of Traditional Chinese Medicine from July 2018 to December 2019 were divided into control group and observation group,according to odd and even grouping method,with 41 cases in each group.The control group was treated with percutaneous vertebroplasty,and the observation group was treated with traditional Chinese medicine sleight reduction combined with percutaneous vertebroplasty.The therapeutic effects and the occurrence of adverse reactions of the two groups were compared.Results The numerical rating scale (NRS) score of the observation group was lower than that of the control group 7 d after surgery,the difference was statistically significant (P < 0.05).Six months after surgery,the Cobb angle of kyphosis in both groups was reduced to varying degrees,and the anterior height of injured vertebrae was increased to varying degrees.The Cobb angle of kyphosis in the observation group was smaller than that in the control group,and the anterior height of injured vertebrae was higher than that in the control group,with statistical significance (P < 0.05).The Oswestry disability index (ODI) score in the observation group was lower than that in the control group 6 months after surgery,and the difference was statistically significant (P < 0.05).The incidence of adverse reactions in the observation group was 4.88%,lower than 12.20% in the control group,and the difference was statistically significant (P < 0.05).The operation time of single vertebral body,intraoperative fluoroscopy time and hospitalization cost in the observation group were all lower than those in the control group,with statistically significant differences(P < 0.05).There was no significant difference in the diffusion coefficient of bone cement between the observation group and the control group (P > 0.05).Conclusion Traditional Chinese medicine manual reduction combined with percutaneous vertebroplasty is safe and effective for patients with osteoporotic vertebral compression fracture.