摘要
目的：本研究通过比较经皮球囊扩张椎体后凸成形术（Percutaneous Kyphoplasty，PKP）及保守疗法（Conservative Medicine Therapy，CMT）治疗骨质疏松性椎体压缩骨折（Osteoporotic Vertebral Compression Fracture，OVCF）引起的全身并发症，探讨 PKP 手术治疗 OVCF 患者的全身并发症情况。方法回顾性分析自2013年1月1日至2014年12月31日收治的120例 OVCF 的高龄老年患者（75～85岁），其中，60例采用 PKP 手术疗法（男19例，女41例）；60例采用保守疗法（男14例，女46例）。所有患者均由 X 片及 MRI 片检查确诊，体检及影像学检查均无脊髓和神经根受压症状，并排除其他病理原因引起的椎体压缩骨折。随访6周内，根据是否出现全身并发症，对治疗前综合情况、治疗后各类并发症发生率进行统计分析，比较 PKP 组与 CMT 组的疗效。结果治疗前，对 PKP 组与 CMT 组在年龄、性别、骨密度的 T 值（BMD）、起始疼痛视觉模拟评分（Visual Analogue Scale，VAS）及症状持续时间等方面进行比较，两组间差异没有统计学意义（p ＞0．05）；治疗后，相比 CMT 组，PKP 组能够显著降低 OVCF 患者并发症的发生率（p ＜0．05），其中，肺部感染、泌尿道感染、便秘和尿潴留等的发生率显著降低（p ＜0．05），差异有统计学意义。男性亚组中，PKP 组能够显著降低 OVCF 患者尿潴留的发生率；女性亚组中，PKP 组能够显著降低 OVCF患者呼吸、泌尿系统等感染性疾病的并发症。结论相比 CMT 组，PKP 组能够显著降低 OVCF 患者全身并发症的发生率。
Abstract
Objectives:To estimate the clinical ef ectiveness of percutaneous kyphoplasty(PKP)for the systemic complications of osteoporotic vegebral compression fractures(OVCFs).A clinical randomized control ed trial was designed to analyse whether systemic complications from patients of OVCF that PKP could reduce.Methods:Retrospective analysis from January2013 to De-cember 2014 during the TCMhospital In NINGBO City,admit ed to Osteoporotic Vertebral Compression Fractures in120 patients for the diagnosis of clinical data,according to the dif erent treat-ment options,divided into two groups,receiving kyphoplasty (PKP group)60 patients,19males,41 women,aged 75 to 85 years,mean age(79.0 ±3.2)years;accepting conservative treatment (control group)60 patients,19 male,female41cases,aged75 to 85years,mean age(80.0 ±2.9)years.Two groups of patients underwent fol ow -up survey,patients were fol owed up 6 weeks.Two groups of gender,age,admission,degree of fracture and osteoporosis,VAS Score,was no significant dif erence(P >0.05),comparable.Systemic complications according to the calculation from SPSS in the al subjects were recorded and comparisons between group PKP and CMT were made during the procedures.Results:PKP group and the CMT group compared to age、sex、BMD、VAS score 、duration of the symptoms before treatment,the dif erence based on t test or chi square test was not statistical y significant(p >0.05).PKP group and the CMT group compared to pulmonary infection、urinary tract infection、constipation、retention of urine after treatment,the dif erence based on chi square test(p <0.05)was in statistical y significant,except venous thrombosis(p >0. 05).Compared to the total systemic complications,was in significant dif erence (p <0.001).PKP group could significantly reduce system complications from the OVCF patients except urinary retention in the male subgroup and respiratory and urinary system infection in the female subgroup. Conclusion:Percutaneous kyphoplasty treatment of Osteoporotic Vertebral Compression Fractures can highly reduce Systemic complications than conservative treatment.
NETL
NSTL
维普
万方数据