摘要
目的:探讨椎体成形术(PVP)联合唑来膦酸治疗老年骨质疏松性胸椎单发椎体压缩骨折(OVCF)合并慢性阻塞性肺疾病(COPD)患者的临床疗效。方法:选取老年COPD并发OVCF患者21例行PVP术,术后2 d静脉滴注唑来膦酸。检测术前及术后1年骨密度(BMD),应用日常生活自理能力(ADL)量表评估患者生活质量;术前、术后1周、1年应用视觉模拟评分法(VAS)评价疼痛程度,监测肺活量(VC)、用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)/FVC的比值(FEV1%);分析VAS与VC、FVC、FEV1%之间的相关性。结果:术后1年ADL评分、腰椎及股骨颈BMD均高于术前,差异有统计学意义(P<0.01或P<0.05)。术后1周,VC和FVC显著优于术前(P<0.01),术后1年时该指标进一步改善(P<0.01)。术后1年,FEV1%值较术前显著改善(P<0.01);Spearman相关分析表明VAS评分与VC(r=-0.916,P<0.05)、FVC(r=-0.981,P<0.05)呈显著负相关。结论:PVP联合唑来膦酸注射液治疗老年OVCF合并COPD患者手术能迅速缓解疼痛,恢复肺功能,改善患者的生活质量,增加患者骨密度。
Objective：To explore percutaneous vertebroplasty（ PVP） combined with zoledronic acid in treatment of compression fracture of thoracic vertebra（OVCF）in elderly patients complicated with chronic obstructive pulmonary disease（COPD）. Methods：A total of 21 COPD patients complicated with OVCF were collected and received PVP surgery. And two days later all patients were given zoledronic acid intravenously. The bone mineral density（ BMD） before and after PVP was detected. Quality of life was assessed by activi-ties of daily living（ ADL） scale. Visual analogue score（ VAS） was applied to evaluate the pain intensity before surgery,and one week and one year after surgery. Along with this the vital capacity（VC）,forced vital capacity（FVC）,1 second forced expiratory volume（FEV1）/FVC ratio（FEV1%）were monitored. Correlations between VAS with VC,FVC and FEV1% were analyzed respectively. Results：ADL scores as well as BMD of lumbar spine and femoral neck were higher one year after PVP than those before surgery and the difference was statistically significant（P〈0. 01 or P〈0. 05）. VC and FVC were obviously better one week later than those before surgery（P〈0. 01）,and the indexes were further improved one year after PVP surgery（P〈0. 01）. One year later FEV1% improved significantly when compared with preoperative（P〈0. 01）. Spearman correlation analysis showed that VAS score was negatively correlated with VC （r= -0. 916,P〈0. 05）and FVC（r= -0. 981,P〈0. 05）. Conclusion：PVP combined zoledronic acid injection in treatment of elder-ly COPD patients with OVCF can rapidly relieve the pain and recover the lung function,then improve the quality of life and increase bone mineral density of patients.
出处
《川北医学院学报》
CAS
2015年第4期458-461,共4页
Journal of North Sichuan Medical College
基金
中国高校医学期刊临床专项资金(11522770)
关键词
椎体成形术
骨质疏松性压缩骨折
唑来膦酸
慢性阻塞性肺疾病
Percutaneous vertebroplasty
Osteoporotic compression fractures
Zoledronic acid
Chronic obstructive pulmonary disease
