| 后凸成形术和保守疗法对椎体骨质疏松性压缩性骨折疗效的对比研究 |
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Received:March 24, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王萧枫 |
WANG Xiao-feng |
温州市中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China |
wzwxfs@139.com |
| 杨益宇 |
YANG Yi-yu |
温州市中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China |
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| 于志华 |
YU Zhi-hua |
温州市中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China |
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| 李祟清 |
LI Chong-qing |
温州市中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China |
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| 吴银生 |
WU Yin-sheng |
温州市中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2010年23卷，第10期，第730-733页 |
| DOI：10.3969/j.issn.1003-0034.2010.10.004 |
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目的：分析经皮椎体后凸成形术( PKP) 和保守疗法治疗骨质疏松性椎体压缩骨折的临床疗效。
方法：回顾性分析2007年9月至2009年4月收治的骨质疏松性椎体压缩骨折63例，男14例，女49例；年龄63～92岁，平均73.4岁。其中30例(38椎)采用PKP法治疗，33例(35椎)采用对症保守治疗，比较两组治疗后随访期内的视觉疼痛评分(VAS)、椎体高度变化及邻椎骨折发生情况。
结果：所有患者均获随访，时间10～15个月，平均13.3个月。PKP组中27例术后1周疼痛得到缓解，VAS评分平均值从术前8.32分下降至2.63分，后期随访VAS平均<2分，保持稳定。保守治疗组治疗1周后VAS分值无变化，在治疗后1、3 个月时VAS分值仍高于PKP组(P<0.05),但6个月以后两组差异无统计学意义(P>0.05).PKP组术后1周椎体高度平均恢复了4.1 mm,有统计学意义(P<0.01),而后保持长期稳定，保守治疗组治疗后椎体高度虽然有改善，但与PKP组比较有统计学差异(P<0.01).新发骨折PKP组有4例(5椎),保守治疗组有2例(2椎).
结论：PKP具有快速止痛、即刻稳定、恢复伤椎高度、早期负重的优势，但可能增加邻椎骨折的风险。保守治疗并不是没有可取之处，只要系统性治疗仍可取得良好的预后。 |
| [关键词]:骨质疏松 脊柱骨折 后凸成形术 病例对照研究 |
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| Percutaneous kyphoplasty and conservative therapy for osteoporotic vertebral compression fractures:a clinical comparative study |
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Abstract:
Objective: To evaluate the clinical effects of percutaneous kyphoplasty (PKP) and conservative therapy in patients with osteoporotic vertebral compression fractures(OVCF).
Methods: The data of 63 patients with OVCF from Sep. 2007 to Apr. 2009 were retrospectively analyzed. There were 14 males and 49 females,ranging in age from 63 to 92 years,with an average of 73.4 years. Among them,30 cases(38 vertebrae),33 cases(35 vertebrae) were respectively treated with PKP,conservative therapy. The VAS score,the height of vertebral body and the neighboring vertebral fracture were observed during follow-up.
Results: All the patients were followed up from 10 to 15 months with an average of 13.3 months. Pain relieved in 27 cases with PKP,and VAS scores decreased from 8.32 before treatment to 2.63 at the 1st week after treatment;VAS scores still remained under 2 at the later follow-up. VAS scores had not changed at the 1st week after conservative therapy. VAS scores with conservative therapy were higher than with PKP after 1,3 months(P<0.05),but after 6 months,there was no significant difference between conservative therapy and PKP(P>0.05). The average height of vertebral body on the X-rays increased in 4.1 mm at the 1st week after treatment with PKP(P<0.01) and unchanged posteriorly. The height of vertebral body had some improvement at 3,6 months after conservative therapy,but the height of vertebral body with PKP was significantly higher than with conservative therapy(P<0.01). New fractures occurred in 4 cases(5 vertebrae) with PKP,in 2 cases(2 vertebrae) with conservative therapy.
Conclusion: PKP is an effective method in treating osteoporotic vertebral compression fractures,which can relieve pain quickly,increase stability immediately,recover height of vertebral body,but maybe can increase the risk of new fracture. Conservative therapy is not without any merit,as long as systemic treatment can still make good prognosis. |
| KEYWORDS:Osteoporosis Spinal fractures Percutaneous kyphoplasty Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王萧枫,杨益宇,于志华,李祟清,吴银生.后凸成形术和保守疗法对椎体骨质疏松性压缩性骨折疗效的对比研究[J].中国骨伤,2010,23(10):730~733 |
| 英文格式: | WANG Xiao-feng,YANG Yi-yu,YU Zhi-hua,LI Chong-qing,WU Yin-sheng.Percutaneous kyphoplasty and conservative therapy for osteoporotic vertebral compression fractures:a clinical comparative study[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(10):730~733 |
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