不同剂量骨水泥椎体成形术对老年胸腰椎骨折患者疼痛反应及椎体功能的影响

Effects of different doses of bone cement vertebroplasty on pain response and vertebral function in elderly patients with thoracolumbar fractures

目的探讨不同剂量骨水泥椎体成形术对老年胸腰椎骨折患者疼痛反应及椎体功能的影响。方法选取2020年1月至2023年1月收治的80例老年胸腰椎骨折患者为研究对象,以随机数字表法将其分为对照组和观察组,各40例。对照组采用常规剂量骨水泥椎体成形术治疗,观察组采用大剂量骨水泥椎体成形术治疗。比较两组的治疗效果。结果术后3 d,观察组的P物质(SP)、前列腺素E2(PGE2)、缓激肽(BK)水平均低于对照组(P<0.05)。术前、术后3 d,两组的椎体前缘压缩率、Cobb角无明显差异(P>0.05)。术后1个月,观察组的Ⅰ型前胶原氨基端前肽(PⅠNP)水平高于对照组,Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平低于对照组(P<0.05)。术后1个月,观察组的白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05)。结论大剂量骨水泥椎体成形术治疗老年胸腰椎骨折对疼痛反应刺激小,能改善椎体功能、骨代谢情况,减轻炎症反应,值得推广。

Objective To explore the effects of different doses of bone cement vertebroplasty on pain response and vertebral function in elderly patients with thoracolumbar fractures.Methods A total of 80 elderly patients with thoracolumbar fractures admitted from January 2020 to January 2023 were selected as the research objects and divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with conventional dose of bone cement vertebroplasty,and the observation group was treated with high dose of bone cement vertebroplasty.The therapeutic effects of the two groups were compared.Results At 3 d after operation,the levels of substance P(SP),prostaglandin E2(PGE2)and bradykinin(BK)in the observation group were lower than those in the control group(P<0.05).Before and 3 d after operation,there were no significant differences in anterior vertebral compression rate and Cobb angle between the two groups(P>0.05).One month after operation,the level of procollagen typeⅠN-terminal propeptide(PⅠNP)in the observation group was higher than that in the control group,and the level of typeⅠcollagen carboxy terminal peptideβspecial sequence(β-CTX)was lower than that in the control group(P<0.05).One month after operation,the levels of interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).Conclusion High dose bone cement vertebroplasty in the treatment of elderly patients with thoracolumbar fractures has less stimulation to pain response,can improve vertebral function and bone metabolism,reduce inflammatory response,which is worthy of promotion.