胸腰椎压缩骨折经皮椎体后凸成形术中注入不同剂量骨水泥疗效分析

Effect of Different Doses of Bone Cement Injection in Percutaneous Kyphoplasty for Thoracolumbar Compression Fractures

目的探究胸腰椎压缩骨折经皮椎体后凸成形术(percutaneous vertebroplasty,PKP)中注入小剂量与常规剂量骨水泥的临床疗效。方法简单随机选取2020年3月—2022年9月江苏省邳州市中医院收治的进行PKP手术的60例患者为研究对象,基于随机数表法分为两组,均接受PKP手术治疗,对照组注射常规剂量骨水泥2.6~5 mL,研究组注射小剂量骨水泥1~2.5 mL,对比观察两组术前及术后3个月随访时椎体前缘高度、Cobb角、Oswerstry功能障碍指数以及应激指标水平并计算并发症发生率。结果两组术后椎体前缘高度、Cobb角、ODI评分均优于术前,差异有统计学意义(P<0.05),但术后组间对比,差异无统计学意义(P>0.05)。两组患者术后炎症应激指标均升高,但研究组低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率为6.67%低于对照组的26.67%,差异有统计学意义(χ^(2)=4.320,P<0.05)。结论胸腰椎压缩性骨折患者PKP手术治疗方案有助于促进患者术后伤椎功能恢复,而小剂量骨水泥注入方法能有效降低术后并发症发生风险,具有较高的安全性,可提高临床疗效。

Objective To explore the clinical efficacy of injecting low dose and conventional dose bone cement in percutaneous vertebroplasty(PKP)for thoracolumbar compression fractures.Methods 60 patients who underwent PKP surgery in Pizhou Hospital of Traditional Chinese Medicine in Jiangsu Province from March 2020 to September 2022 as the research objects were simple randomly selected,and divided them into two groups based on the method of random number table.Both of them received PKP surgery.the control group injected 2.6~5 mL bone cement of conventional dose,and the research group injected 1~2.5 mL bone cement of small dose.The height of the anterior edge of the vertebral body,Cobb angle,Oswestry Dysfunction Index emergency indicator level were compared and observed between the two groups before and after 3 months of follow-up,and the incidence of complications was calculated.Results The anterior edge height,Cobb angle,and ODI score of the two groups after surgery were all better than those before surgery,the difference was statistically significant(P<0.05).However,there was no statistically significant difference between the groups after surgery(P>0.05).The postoperative inflammatory stress indicators of both groups of patients increased,but the study group were lower than the control group,the difference was statistically significant(P<0.05).The incidence of complications in the study group was 6.67%lower than that in the control group(26.67%),the difference was statistically significant(χ^(2)=4.320,P<0.05).Conclusion PKP surgical treatment scheme for patients with thoracolumbar compression fractures is helpful to promote the recovery of injured vertebral function,and lowdose bone cement injection method can effectively reduce the risk of postoperative complications.