阿仑膦酸钠治疗骨质疏松性脊柱压缩性骨折椎体成形术后残余疼痛的早期疗效观察

Early efficacy of alendronate in treatment of osteoporotic vertebral compression fractures vertebroplasty postoperative residual pain

目的研究阿仑膦酸钠治疗骨质疏松性脊柱压缩性骨折(osteoporotic vertebral compression fractures,OVCF)椎体成形术后残余疼痛的早期疗效。方法选取2013年9月~2014年10月期间浙江省磐安县人民医院收治的62例OVCF患者,按照入院顺序将患者分为观察组和对照组,每组各31例。所有患者在术后1 d均给予碳酸钙D3片,观察组患者在此基础上使用阿仑磷酸钠。比较2组患者治疗前和治疗半个月、1个月及2个月后的疼痛程度评分,观察2组患者的疼痛改善情况,比较2组患者治疗前后的活动能力评分、止痛药使用及骨密度情况。结果观察组患者术后1个月的疼痛程度评分为(0.8±0.4)分,术后2个月的疼痛评分为(0.4±0.2)分,均显著低于对照组[(1.6±0.7)分;(1.1±0.8)分,P<0.05];观察组患者的疼痛优良率为83.87%,显著高于对照组的58.06%(P<0.05);治疗后,观察组患者的活动能力评分为(1.13±0.53)分,止痛药使用情况为(0.44±0.07)次/d,均显著低于对照组(1.79±0.89)分,(0.89±0.12)次/d(P<0.05),但骨密度水平(5.78±1.02)%显著高于对照组(3.21±0.79)%(P<0.05)。结论阿仑膦酸钠治疗OVCF椎体成形术后残余疼痛具有较好的早期疗效,并且不良反应少,安全性相对较高。

Objective To study the efficacy of alendronate in treatment of postoperative residual pain with osteoporotic vertebral compression fractures( OVCF) of vertebroplasty. Methods 62 patients with OVCF from September 2013 to October 2014 were divided into observation group and control group,each had 31 cases. All patients were given calcium carbonate D3 tablets 1 day after surgery,observation group were given alendronate on this basis. The degree of pain score between two groups pre-and post-treatment two weeks,one month,two months were observed and compared. Pain improvement in two groups were observed,and activity ability score,painkiller use and bone mineral density between two groups pre-and post-treatment were compared. Results The pain scores in observation group a month postoperative was( 0. 8 ± 0. 4) points and( 0. 4 ± 0. 2) points after two months,were significantly lower than those in control group[( 1. 6 ± 0. 7) points,( 1. 1 ± 0. 8) points,P < 0. 05]. The excellent rate of pain improvement in observation group( 83. 87%) was significantly higher than that in control group( 58. 06%,P < 0. 05). After treatment,activity ability score in observation group was( 1. 13 ± 0. 53) points and painkiller usage was( 0. 44 ± 0. 07) times per day,all significantly lower than those in control group[( 1. 79 ± 0. 89) points,( 0. 89 ± 0. 12) times per day,P < 0. 05]. BMD level in observation group was( 5. 78 ± 1. 02) %,higher than that in control group[( 3. 21 ± 0. 79) %,P < 0. 05]. Conclusion Alendronate in treatment of osteoporotic vertebral compression fractures vertebroplasty postoperative residual pain has good early outcome and low adverse reactions,and security is relatively high.