| 经皮椎体成形术治疗骨质疏松性椎体压缩性骨折并发症原因分析及预防 |
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投稿时间：2009-04-24
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| 作者 | Author | 单位 | Address | E-Mail |
| 王恒龙 |
WANG Heng-long |
晋中市第一人民医院骨科,山西 晋中 030600 |
Department of Orthopaedics,the 1st People's Hospital of Jinzhong, Jinzhong 030600,Shanxi,China |
wangzhigang5258@163.com |
| 姜振国 |
JIANG Zhen-guo |
晋中市第一人民医院骨科,山西 晋中 030600 |
Department of Orthopaedics,the 1st People's Hospital of Jinzhong, Jinzhong 030600,Shanxi,China |
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| 王志刚 |
WANG Zhi-gang |
晋中市第一人民医院骨科,山西 晋中 030600 |
Department of Orthopaedics,the 1st People's Hospital of Jinzhong, Jinzhong 030600,Shanxi,China |
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| 朱剑 |
ZHU Jian |
晋中市第一人民医院骨科,山西 晋中 030600 |
Department of Orthopaedics,the 1st People's Hospital of Jinzhong, Jinzhong 030600,Shanxi,China |
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| 赵宏涛 |
ZHAO Hong-tao |
晋中市第一人民医院骨科,山西 晋中 030600 |
Department of Orthopaedics,the 1st People's Hospital of Jinzhong, Jinzhong 030600,Shanxi,China |
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| 期刊信息：《中国骨伤》2009年，第22卷，第10期，第783-784页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：分析经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性胸腰椎压缩性骨折并发症的原因，并提出防治措施。
方法：自2004年5月至2008年6月，采用C形臂X线机透视下经皮椎体成形术204例(286个椎体),发生并发症56例，其中男18例，女38例；年龄58～93岁，平均72岁。观察其骨水泥渗漏和并发症发生情况。
结果：与骨水泥渗漏相关的并发症49例，60个椎体，其中渗漏到椎管内5例，渗漏到神经根管3例，渗漏到椎旁软组织20 例，渗漏到相邻椎间盘15 例，渗漏到椎旁静脉丛6 例。与骨水泥渗漏无关的并发症7例，其中穿刺损伤神经根3例，一过性疼痛加剧2例，一过性血压降低2例。
结论：导致并发症发生的主要原因有穿刺椎体的骨皮质不完整，骨水泥本身的毒性，操作技术不规范，不能准确掌握骨水泥注入时机和注入量，术中C形臂X线机透视监测不充分等。预防措施主要有：严格掌握PVP的手术适应证，规范手术操作，术中充分的X线透视监测，准确掌握骨水泥注入时机和注入量，术中心电监护。 |
| 【关键词】经皮椎体成形术 骨质疏松 椎体压缩性骨折 手术后并发症 |
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| Analysis of the complication and prevention on treatment of osteoporotic vertebral compressive fractures by percutaneous vertebroplasty(PVP) |
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ABSTRACT
Objective: To analyze the reasons of the complications,and the measures taken for the prevention and treatment by percutaneous vertebroplasty(PVP) for osteoporotic thoracolumbars vertebral compressive fractures.
Methods: From May 2004 to June 2008,204 patients with 286 diseased vertebrae underwent PVP under the guidance of C-arm fluoroscopy,and 56 patients with complications included 18 males,38 females ,ranging in age from 58 to 93 years,with an average of 72 years. The condition of leakage of bone cement and complications was observed.
Results: The complications related to the leakage of PMMA found in 60 vertebrae in 49 cases:vertebral canal in 5 cases,intervertebral foramina in 3 cases,soft tissue besides vertebrae in 20 cases,intervertebral discs in 15 cases,venous plexus besides vertebrae in 6 cases. The complications no related to the leakage of PMMA found in 7 cases:the nerve roots injuried in 3 cases;the pain of the patient worsened temporarily in 2 cases;the blood pressure of the patient descent temporarily in 2 cases.
Conclusion: The main reasons of complications are no-integrated of the compressived vertebrae,unstandard skills of injecting,unsuitable opportunity and quantity of injecting PMMA,unsufficient monitoring of C-arm fluoroscopy,the toxicity of PMMA.The measures of prevention and treatment is strict indication,standard skills of injecting,sufficient monitoring of C-arm fluoroscopy,suitable opportunity and quantity of injecting PMMA,electrocardio-monitoring in operation. |
| KEY WORDS Percutaneous vertebroplasty(PVP) Osteoporosis Compression fractures of vertabral body Postoperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王恒龙,姜振国,王志刚,朱剑,赵宏涛.经皮椎体成形术治疗骨质疏松性椎体压缩性骨折并发症原因分析及预防[J].中国骨伤,2009,22(10):783~784 |
| 英文格式: | WANG Heng-long,JIANG Zhen-guo,WANG Zhi-gang,ZHU Jian,ZHAO Hong-tao.Analysis of the complication and prevention on treatment of osteoporotic vertebral compressive fractures by percutaneous vertebroplasty(PVP)[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(10):783~784 |
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