摘要
目的比较经皮椎体成形术(PVP)和保守治疗对慢性疼痛性骨质疏松性椎体骨折患者在疼痛缓解和功能恢复方面的疗效。方法 81例患者分成两组,分别施行PVP(n=41,A组)或保守治疗(n=40,B组)。患者均经MRI证实患有慢性压缩性骨折,且疼痛持续在3个月或以上。观察两组患者在治疗后1周,1、3、6个月和1年的疼痛缓解和功能恢复情况。结果共有71例(A组37例和B组34例)完成了1年随访评估。通过在1周,1、3、6个月和1年的视觉模拟评(VAS)评分、功能障碍指数评分、欧洲基金会关于骨质疏松症的生活品质问卷评分和罗兰莫里斯残疾评分显示,A组在疼痛缓解和功能恢复方面显著优于B组,各时间点两组差异均有统计学意义(P均<0.01)。最终的临床随访评估中A组有30例、B组13例患者疼痛达到完全缓解(P<0.01)。结论 PVP在治疗慢性压缩性骨折和持续性疼痛的缓解及功能恢复方面优于保守治疗。
Objective To compared the therapeutic efficacy （relieving pain and restoring function） of percutaneous vertebroplasty （PVP） with that of conservative measures （CM） for chronic painful osteoporotic spinal fractures. Methods A total of 81 patients with MRI- proved chronic compression fractures and persistent severe pain lasting for 3 months or more were enrolled in this study. Based on the treatment received, the patients were divided into PVP group （n = 41） and CM group （n = 40）. The degrees of pain relief and function recovery at one week, one, 3, 6 and 12 months after the treatment were evaluated. The results were compared between the two groups. Results One-year follow-up evaluation was accomplished in 37 patients of PVP group and in 34 patients of CM group. The degrees of pain rehef and function recovery of PVP group were significantly better than those of CM group. The differences in visual analogue scale （VAS） scores, in Oswestry disability index （ODI） scores, in Quality of Life Questionnaire of the European Foundation for Osteoporosis （QUALEFFO） and in Roland Morris Disability （RMD） determined at one week, one, 3, 6 and 12 months after the treatment between the two groups were statistically significant （P 〈 0.001 ） for all the above listed items）. The final clinical follow-up evaluation showed that complete pain-free was obtained in 30 patients of PVP group and in 13 patients of CM group （P 〈 0.001）. Conclusion For the treatment of chronic compression fractures with persistent severe pain, percutaneous vertebroplasty is superior to conservative measures in relieving pain and restoring function.
出处
《介入放射学杂志》
CSCD
北大核心
2012年第11期921-926,共6页
Journal of Interventional Radiology
关键词
骨质疏松性椎体压缩骨折
疼痛
经皮椎体成形术
保守治疗
osteoporotic vertebral compression fracture
pain
percutaneousvertebroplasty
conservative treatment
