首页|PVP与保守治疗在骨质疏松性椎体极重度压缩性骨折中的应用效果

PVP与保守治疗在骨质疏松性椎体极重度压缩性骨折中的应用效果

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目的:分析经皮椎体成形术(percutaneous vertebroplasty,PVP)与保守治疗在骨质疏松性椎体极重度压缩性骨折中的应用效果。方法:回顾性选取 2020 年 2 月—2022 年 12 月徐州矿务集团第一医院收治的 91 例骨质疏松性椎体极重度压缩性骨折患者的资料。根据治疗方法的不同将其分为保守组(42 例)及手术组(49 例)。保守组采取保守治疗,手术组采取PVP治疗。比较两组治疗前,治疗后7 d,治疗后90 d,治疗后6个月疼痛程度、功能障碍、后凸角、骨密度。结果:治疗后7 d、90 d、6 个月,两组视觉模拟评分法(visual analogue scale,VAS)评分均降低,保守组VAS评分均低于手术组,差异有统计学意义(P<0。05)。治疗后 7 d、90 d、6 个月,两组Oswestry功能障碍指数(Oswestry disability index,ODI)评分均降低,手术组ODI评分均低于保守组,差异有统计学意义(P<0。05)。治疗后 7 d、90 d、6 个月,手术组后凸角低于治疗前及保守组,保守组治疗后 90 d后凸角高于治疗前及治疗后 7 d,治疗后 6 个月后凸角高于治疗后 7 d,差异有统计学意义(P<0。05)。治疗后 7 d、90 d、6 个月,两组骨密度比较,差异无统计学意义(P>0。05);治疗后 90 d、6 个月,两组骨密度均高于治疗前及治疗后 7 d,手术组治疗后 6 个月骨密度高于治疗后 90 d,差异有统计学意义(P<0。05)。结论:PVP及保守治疗均可治疗骨质疏松性椎体极重度压缩性骨折,提升骨密度,其中PVP在改善功能及后凸角方面的疗效更好,保守治疗在减轻疼痛方面的疗效更好。
Application Effect of PVP and Conservative Therapy in the Extremely Severe Compression Fractures of the Osteoporotic Vertebral Body
Objective:To analyse the application effect of percutaneous vertebroplasty(PVP)and conservative therapy in the extremely severe compression fractures of the osteoporotic vertebral body.Method:The data of 91 patients with extremely severe compression fractures of the osteoporotic vertebral body admitted to the the First Hospital of Xuzhou Mining Group from February 2020 to December 2022 were retrospectively selected.According to the different treatment methods,they were divided into conservative group(42 cases)and operation group(49 cases).The conservative group received conservative treatment,and the operation group received PVP treatment.The degree of pain,dysfunction,kyphosis angle and bone density were compared between the two groups before treatment,7 d,90 d and 6 months after treatment.Result:At 7 d,90 d and 6 months after treatment,the visual analogue scale(VAS)scores of both groups were decreased,and the VAS scores of the conservative group were lower than those of the operation group,the differences were statistically significant(P<0.05).At 7 d,90 d and 6 months after treatment,the Oswestry disability index(ODI)score of both groups were decreased,and the ODI score of the operation group were lower than those of the conservative group,the differences were statistically significant(P<0.05).At 7 d,90 d and 6 months after treatment,the kyphosis angle in the operation group were lower than those before treatment and conservative group,the kyphosis angle in the conservative group at 90 d after treatment was higher than that before treatment and 7 d after treatment,and the kyphosis angle at 6 months after treatment was higher than that 7 d after treatment,the differences were statistically significant(P<0.05).At 7 d,90 d and 6 months after treatment,there were no significant differences in bone mineral density between the two groups(P>0.05).At 90 d and 6 months after treatment,bone mineral density in both groups were higher than those before treatment and 7 d after treatment,and bone mineral density in operation group was higher at 6 months than 90 d after treatment,the differences were statistically significant(P<0.05).Conclusion:Both PVP and conservative treatment can treat extremely severe compression fractures of the osteoporotic vertebral body and improve bone mineral density.PVP is more effective in improving function and kyphotic angle,and conservative treatment is more effective in reducing pain.

Percutaneous vertebroplastyConservative treatmentOsteoporosisExtremely severe compression fractures of the vertebral body

刘江、刘鹏、解腾、孙周

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徐州矿务集团第一医院 江苏 徐州 221122

经皮椎体成形术 保守治疗 骨质疏松 椎体极重度压缩性骨折

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(8)
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