[1]柴仪,田伟明,温志刚.经皮椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折的疗效分析[J].中华老年骨科与康复电子杂志,2016,(03):150-154.[doi:10.3877/cma.j.issn.2096-0263.2016.03.005]
　Chai Yi,Tian Weiming,Wen Zhigang.Curative effective analysis of percutaneous kyphoplasty for osteoporotic vertebral compression fracture in senile patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(03):150-154.[doi:10.3877/cma.j.issn.2096-0263.2016.03.005]
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经皮椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折的疗效分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年03期
页码:
150-154
栏目:
骨质疏松
出版日期:
2016-08-05

文章信息/Info

Title:
Curative effective analysis of percutaneous kyphoplasty for osteoporotic vertebral compression fracture in senile patients
作者:
柴仪; 田伟明; 温志刚
050000 石家庄，河北省中医院骨伤一科
Author(s):
Chai Yi;  Tian Weiming;  Wen Zhigang
Department of Orthopaedics, Hebei Province Hospital of TCM, Shijiazhuang 050000, China
关键词:
椎体成形术; 　老年人;  80 以上; 　骨质疏松性骨折; 　术后并发症
Keywords:
Vertebroplasty;  Aged;  80 and over;  Osteoporotic fractures;  Postoperative complications
DOI:
10.3877/cma.j.issn.2096-0263.2016.03.005
文献标志码:
A
摘要:
目的 探讨经皮椎体后凸成形术（PKP）治疗高龄骨质疏松性压缩骨折（OVCF）患者的临床疗效及相关并发症的预防。 方法　回顾性分析河北省中医院骨伤一科自 2010 年 7 月至 2013 年 3 月采用单侧椎弓根途径 PKP 手术治疗 68 例高龄（＞ 80 岁） OVCF 患者，其中单椎体 43 例（63.2%），两椎体 18 例（26.5%），三椎体 7 例（10.3%）。所有患者均在 C 型臂 X 机动态监视下完成单侧 PKP 手术，观察患者手术前后疼痛视觉模拟评分（VAS）变化、椎体平均高度、局部 Cobb 角改善及近远期并发症的发生情况。 结果 60 例患者获得 12 ～ 20 个月随访，随访期间共 7 例（10.29%）患者继发椎体骨折（其中 6 例为临近椎体骨折）。术后即刻及末次随访时 VAS 评分、椎体平均高度及局部 Cobb 角均较术前改善（F=277.235； F=19.682； F=43.686，均 P ＜ 0.01）。术中发生骨水泥椎旁渗漏 6 例（8.82%）、血压一过性降低 3 例（4.41%）、骨水泥肺栓塞 1 例（1.47%），经及时处理未出现生命危险。 结论　经单侧椎弓根途径 PKP 手术治疗高龄 OVCF 患者可获得满意的临床效果，但高龄患者术中及术后并发症发生率较高，需采用针对性的方法进行防范。
Abstract:
Objective To investigate the clinical effcacy of percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF) and prevention strategies for compliations. Methods A retrospectively study was performed including 68 elderly patients with OVCF who underwent PKP through an unipedicular approach, there were 18 men (26.5%) and 50 women (73.5%), the average age was 87±10 years (range, 80-97 years), there were 43 single-vertebra, 18 dual-vertebra and 7 triple-vertebra. The observation items of visual analogue scale (VAS), Cobb angle recovery, vertebral height restoration and complications were calculated pre-and-post operation. Results All patients had a follow-up range from 12 to 20 months and 7 patients had secondary vertebral fractures. Compared with preoperation, the score of VAS, local Cobb’s angle and average vertebral height had a signifcant improvement than post-operation and the fnal follow-up in 3 groups (F=277.235, F=19.682, F=43.686, P<0.01). A total of 6 patients had bone cement leakage, 3 cases occurred transient decrease in blood pressure and 1 patient occurred pulmonary embolism during operation, but without any symptom left after an anticoagulant therapy. Conclusions Unilateral pedicle approach of PKP in treatment of elderly patients can achive an effective therapy. However, the targeted prevention measures should be given due to its high incidence of postoperative complications in elderly patients

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备注/Memo

备注/Memo:
基金项目：河北省中医药管理局课题（2012024）
更新日期/Last Update: 2017-04-01