老年骨質(zhì)疏松性脊柱骨折患者應(yīng)用經(jīng)皮椎體成形術(shù)的治療效果分析

代德勇

[摘要] 目的 探討老年骨質(zhì)疏松性脊柱骨折患者應(yīng)用經(jīng)皮椎體成形術(shù)的治療效果。 方法 方便選擇該院2017年3月—2019年4月收治的98例老年骨質(zhì)疏松性脊柱骨折患者為研究對(duì)象，按照不同手術(shù)方式分為試驗(yàn)組與參照組。試驗(yàn)組患者實(shí)施經(jīng)皮椎體成形術(shù)治療，參照組患者實(shí)施短節(jié)段椎弓根釘內(nèi)固定術(shù)治療。觀察與比較兩組患者術(shù)后后凸 Cobb 角、傷椎前緣高度、傷椎后緣高度、疼痛評(píng)分、日常生活能力評(píng)分以及治療總有效率。 結(jié)果 試驗(yàn)組術(shù)后后凸Cobb角角度，傷椎前緣高度、傷椎后緣高度明顯優(yōu)于參照組，差異有統(tǒng)計(jì)學(xué)意義（t=3.964、4.067、4.182，P<0.05）;試驗(yàn)組術(shù)后VAS、Barthel評(píng)分明顯優(yōu)于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t=4.306、4.162，P<0.05），試驗(yàn)組治療總有效率95.92%明顯高于對(duì)照組79.59%，差異有統(tǒng)計(jì)學(xué)意義（χ2=5.303，P<0.05）。 結(jié)論 對(duì)老年骨質(zhì)疏松性脊柱骨折患者應(yīng)用經(jīng)皮椎體成形術(shù)治療療效更為確切，患者術(shù)后疼痛程度較輕，對(duì)患者日常生活影響較小，值得應(yīng)用。

[關(guān)鍵詞] 骨質(zhì)疏松性脊柱骨折;經(jīng)皮椎體成形術(shù);短節(jié)段椎弓根釘內(nèi)固定;治療效果

[中圖分類號(hào)] R816.8 ? ? ? ? ?[文獻(xiàn)標(biāo)識(shí)碼] A ? ? ? ? ?[文章編號(hào)] 1674-0742（2020）10（a）-0042-03

Analysis of the Therapeutic Effect of Percutaneous Vertebroplasty in Elderly Patients with Osteoporotic Spine Fractures

DAI De-yong

Department of Orthopedics， Guanxian People's Hospital， Guanxian， Shandong Province， 252500 China

[Abstract] Objective To investigate the therapeutic effect of percutaneous vertebroplasty in elderly patients with osteoporotic spine fractures. Methods A total of 98 elderly patients with osteoporotic spine fractures who were admitted to the hospital from March 2017 to April 2019 were convenient selected as the subjects of this study and divided into experimental group and reference group according to different surgical methods. Patients in the experimental group were treated with percutaneous vertebroplasty， and patients in the reference group were treated with short-segment pedicle screw internal fixation. The postoperative kyphotic Cobb angle， the height of the anterior edge of the injured vertebra， the height of the posterior edge of the injured vertebra， the pain score， the ability of daily living score and the total effective rate of treatment were observed and compared between the two groups. Results The experimental groups postoperative kyphotic Cobb angle， the height of the anterior edge of the injured vertebra， and the height of the posterior edge of the injured vertebrae were significantly better than those of the reference group， the difference was statistically significant（t=3.964，4.067，4.182， P<0.05）; VAS and Barthel scores were significantly better than those of the control group， and the differences were statistically significant （t=4.306， 4.162， P<0.05）. The total effective rate of treatment in the experimental group was 95.92% significantly higher than that of the control group 79.59%， and the differences were statistically significant（χ2=5.303，P<0.05）. Conclusion Percutaneous vertebroplasty is more effective in the treatment of elderly patients with osteoporotic spine fractures. The postoperative pain of the patients is less and it has less impact on the patients' daily life. It is worthy of application.

經(jīng)皮椎體成形術(shù)是一種微創(chuàng)手術(shù)，其已經(jīng)被廣泛的應(yīng)用于椎體骨折臨床治療中。經(jīng)皮椎體成形術(shù)通過向骨折部位椎體內(nèi)注入骨水泥等材料，增強(qiáng)骨折部位椎體的高度與強(qiáng)度，使受損椎體更加穩(wěn)定。既往研究表明[8]，經(jīng)皮椎體成形術(shù)能夠明顯增強(qiáng)骨質(zhì)的強(qiáng)度，能夠降低患者術(shù)后長(zhǎng)期臥床可能出現(xiàn)的壓瘡等并發(fā)癥的幾率，有利于避免病變椎體進(jìn)一步塌陷。同時(shí)，經(jīng)皮椎體成形術(shù)可以有效恢復(fù)患者椎體生物力學(xué)性能，同時(shí)也可以使脊髓神經(jīng)根部分減壓，可達(dá)到減輕疼痛的效果。

該文研究結(jié)果顯示，試驗(yàn)組術(shù)后后凸Cobb角角度（8.92±1.74）°低于參照組（13.04±1.61）°，傷椎前緣高度（83.27±2.46）%、傷椎后緣高度（82.69±5.11）%明顯高于參照組（76.05±2.52）%、（76.87±5.04）%（P<0.05）;試驗(yàn)組術(shù)后VAS評(píng)分為（1.29±0.83）分、Barthel評(píng)分為（88.23±3.42）分明顯優(yōu)于對(duì)照組（3.05±0.74）分、（72.11±3.37）分（P<0.05），試驗(yàn)組治療總有效率95.92%明顯高于對(duì)照組79.59%（P<0.05）。上述結(jié)果與王自剛等人[9]研究結(jié)果：手術(shù)組治療總有效率95%明顯高于保守組78%（P<0.05），基本一致。

綜上所述，對(duì)老年骨質(zhì)疏松性脊柱骨折患者應(yīng)用經(jīng)皮椎體成形術(shù)治療療效更為確切，患者術(shù)后疼痛程度較輕，對(duì)患者日常生活影響較小。

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（收稿日期：2020-07-04）