作　　者： ; ;

机构地区： 佛山市中医院

出　　处： 《广西医学》 2019年第14期1745-1748,共4页

摘　　要： 目的观察聚甲基丙烯酸甲酯(PMMA)骨水泥联合改性骨粉在骨质疏松性椎体压缩骨折(OVCF)中的应用效果。方法选择46例拟行经皮椎体成形术(PVP)治疗的OVCF患者,分成观察组与对照组各23例。观察组术中采用PMMA骨水泥联合改性骨粉进行伤椎填充,对照组术中仅采用PMMA骨水泥进行伤椎填充。记录术后随访期间两组患者相关并发症的发生情况,并比较两组患者术前、术后2d、术后半年及末次随访时伤椎Cobb角、疼痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI)评分。结果两组患者均顺利完成手术,观察组术中均无骨水泥渗漏,对照组术中有3例出现骨水泥渗漏。两组患者术后均未发生排斥反应、骨水泥毒性、肺栓塞、感染等并发症发生。随访期间观察组无邻椎骨折发生,对照组出现2例邻椎骨折。两组的Cobb角、VAS评分及ODI评分比较,差异均有统计学意义,均有随时间变化的趋势,且观察组术后上述指标改善优于对照组(均P<0.05)。结论PVP术中采用PMMA骨水泥联合改性骨粉进行伤椎填充的疗效优于单纯使用PMMA骨水泥填充,安全性高,术后邻椎再发骨折风险低。 Objective To observe the application effect of polymethylmethacrylate(PMMA) bone cement combined with modified bone powder on osteoporotic vertebral compression fracture(OVCF). Methods Forty-six patients with OVCF who underwent percutaneous vertebroplasty(PVP) were enrolled and divided into observation group and control group,with 23 cases in each group.The observation group used PMMA bone cement combined with modified bone powder for injured vertebrae filling during operation,while the control group used PMMA bone cement alone for injured vertebrae filling during operation.The incidence of relevant complication was recorded in the two groups during postoperative follow-up period.Cobb angle of the injured vertebrae,Visual Analogue Scale(VAS) score for pain,and Oswestry Disability Index(ODI) score were compared between the two groups before operation,2 days after operation,6 months after operation and at the last follow-up. Results The operation was successfully completed in both groups.There was no intraoperative leakage of bone cement in the observation group and 3 cases in the control group.There were no complications such as rejection,toxicity of bone cement,pulmonary embolism and infection in the two groups.During the follow-up period,no recurrence of adjacent vertebral fractures relapsed in the observation group,and 2 cases in the control group.Cobb angle,VAS scores and ODI showed statistically significant differences scores between the two groups (all P <0.05),presenting a time-dependent trend(all P <0.05),and after treatment,the indices mentioned above in the observation group were superior to those in the control group(all P <0.05). Conclusion Intra-PVP PMMA bone cement combined with modified bone powder is superior to PMMA bone cement alone in efficacy for injured vertebrae filling,with high safety and low risk of recurrent fracture of adjacent vertebrae after operation.

关 键 词： 骨质疏松性椎体压缩骨折 聚甲基丙烯酸甲酯 骨水泥 改性骨粉 经皮椎体成形术 临床疗效

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