骨质疏松性椎体压缩骨折患者PVA术后继发邻椎骨折的多因素分析

目的分析骨质疏松性椎体压缩骨折(OVCF)患者经皮椎体强化术(PVA)治疗后继发邻椎骨折的危险因素,为临床预防提供理论依据。方法回顾性分析2019年5月至2020年12月在泰兴市人民医院接受手术治疗的62例OVCF患者的临床资料,根据术后是否发生邻锥骨折分为骨折组20例和非骨折组42例。制作继发邻锥骨折的危险因素调查表调查明确相关因素,并进行单因素分析和Logistic回归多因素分析。结果经单因素分析结果显示,两组患者的年龄、伤椎数、骨水泥是否渗漏、骨密度以及骨折程度是OVCF患者PVA术后邻椎骨折的相关因素(P<0.05);Logistic回归多因素分析结果显示,年龄大、伤椎数>2个、骨水泥渗漏、骨折程度严重以及骨密度低是PVA术后邻椎骨折的危险因素(P<0.05)。结论年龄大、伤椎数多、骨水泥发生渗漏、骨折程度严重以及骨密度低是OVCF患者PVA术后继发邻椎骨折的危险因素,临床上应重视这些危险因素,防止术后邻椎骨折。

瑞舒伐他汀及唑来膦酸联合PVP术治疗老年压缩性骨折疗效观察

目的观察瑞舒伐他汀及唑来膦酸联合经皮椎体成形术(PVP)治疗老年压缩性骨折的疗效。方法选择2019年1月至2020年3月泰兴市人民医院收治的65例老年压缩性骨折患者为研究对象。根据随机单双数法将患者分为对照组32例和联合组33例。对照组患者使用PVP术治疗,联合组在对照组治疗的基础上联合使用瑞舒伐他汀及唑来膦酸治疗。12个月后,比较两组患者的临床疗效、骨密度、Oswestry功能障碍指数、视觉模拟评分(VAS)、血骨钙素(BGP)、I型胶原交联羧基端肽(CTXI)、I型胶原交联氨基端肽(NTXI)以及骨特异性碱性磷酸酶(BAP)水平。结果联合组患者的治疗总有效率为96.97%,明显高于对照组的78.13%,差异有统计学意义(P<0.05);治疗前,两组患者的骨密度、Oswestry指数与VAS评分比较差异均无统计学意义(P>0.05),治疗后,联合组患者的骨密度为(0.55±0.14)g/cm^(3),明显高于对照组的(0.46±0.10)g/cm^(3),Oswestry指数为(21.25±3.08)分,明显低于对照组的(28.97±3.32)分,差异均有统计学意义(P<0.05);联合组患者治疗3个月和治疗12个月后的VAS评分分别为(4.66±1.25)分和(3.82±0.95)分,明显低于对照组的(6.53±1.64)分和(2.33±0.69)分,差异均有统计学意义(P<0.05);治疗后,联合组患者的BGP、CTXI、NTXI、BAP水平分别为(3.03±0.69)μg/L、(29.21±3.24)ng/L、(2.95±0.82)nmol/L、(13.79±4.68)μg/L,明显低于对照组的(6.37±1.84)μg/L、(42.01±5.08)ng/L、(4.14±0.78)nmol/L、(19.25±5.33)μg/L,差异均有统计学意义(P<0.05)。结论瑞舒伐他汀及唑来膦酸联合PVP术治疗老年压缩性骨折能明显改善患者的疼痛程度及功能障碍,降低骨代谢指标,临床治疗效果显著,值得推广应用。

Bainite Growth Behavior at Early Stage of Transformation in a High Carbon Silicon-Containing Steel

The growth behavior at the early stage of bainitic transformation was investigated using optical microscopy,X-ray diffraction analysis and transmission electronic microscopy.The bainite was obtained by isothermal transformation at 200 ℃ only for a short time in a high carbon silicon-containing steel after austenitization at 200 ℃ only for 20 min.Transmission electronic microscopy shows that the bainite appears in the form of plates with a width of about 30 nm,and that the interface of the bainite leading tip is wedge shaped.X-ray diffraction analysis reveals that the bainite plates consist of single ferrite phase,with absence of carbides.The results confirm the occurrence of the moiré which suggests the existence of austenite grain boundaries at the bainite leading tip.Both the lateral growth and longitudinal growth of bainite have weak ability to traverse the lattice-distortion strain fields and austenite grain boundary.The austenite grain boundary impedes the longitudinal growth of the bainite plate,i.e.,the growth of bainite plate stops at the austenite grain boundary.The longitudinal growth of bainite associated with the features of shear mechanism can not completely be in accordance with that of martensitic transformation.