摘要
[目的]探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)及后凸成形术(percutaneous kyphoplasty,PKP)的长期临床治疗效果。[方法]72例诊断为骨质疏松性椎体压缩性骨折的老年患者(>60岁)被纳为研究对象,接受PVP手术的32例为PVP组,而接受PKP手术的40例为PKP组。使用疼痛视觉评估表(visual analog scale,VAS)对两组患者术前、术后第3 d、6个月及2年时疼痛程度进行评分,并测量骨折椎体前缘高度(vertebral body height,VH)及局部后凸角(local kyphosis angle,LKA),使用SF-36生活质量调查表对术前及术后6个月、2年随访时患者的生活质量(quality of life,QOL)进行评分,并进行比较。[结果]两组术后VAS值均明显低于术前,且差异具有统计学意义(P<0.001),VH均明显增高,LKA均明显降低,PKP组的改善程度明显优于PVP组(P<0.01)。两组患者SF-36问卷的8个指标均较术前有明显改善(P<0.01),术后6个月、2年时PKP组患者在社会功能及精神健康方面优于PVP组且差异有统计学意义(P<0.05)。[结论]两种手术方式均能明显缓解疼痛;在恢复椎体高度、纠正后凸畸形方面PVP和PKP都有效果,但PKP优于PVP;两种手术方式都能显著提高患者的QOL,PKP患者能够很快从疾病的阴影中走出,精神压力减轻,从而提高了社会功能。
[ Objective]To investigate and compare the long- term clinical results of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP）. [ Method ] Seventy - two elderly （ 〉 60 years old） patients diagnosed with osteoporotic vertebral body compression fractures were involved in this study. Thirty - two patients were divided in the PVP group and another 40 patients,divided in the PKP group. The pain value of two group patients were investigated and compared by using visual ana- log scale （VAS）. Anterior height of fracture vertebral body （VH） and local kyphosis angle （LKA） were measured and com- pared before the surgery and at the third days, six months ,two years after the surgery. The quality of life （QOL） of patients was investigated and compared by using the SF - 36 questionnaire preoperatively and at 6 months ,2 years postoperatively. [ Result] The VAS value of two groups postoperatively decreased significantly than that before operation （ P 〈 0.001 ）. VH increased, and LKA decreased significantly after surgery when compared with those before the surgery, and the improvement of kyphosis in PKP group was significantly better than that of PVP group （ P 〈 0. O1 ）. Eight indexes of SF - 36 questionnaire of two groups improved significantly postoperatively （P 〈 O. 01 ）. Six months and two years after the surgery, the social function and mental health of PKP group patients improved significantly than those of PVP group （ P 〈 0.05 ）. [ Conclusion ] Both PVP and PKP can relieve pain significantly. Both of the two operation methods are effective in the recovery of the vertebral height and kyphosis correction and PKP is superior than PVP. PVP and PKP can also improve the patient＇s QOL significantly. Patients undergoing PKP will re- cover from illness, relieve the stress quickly, so as to improve the personal social function.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第22期2021-2025,共5页
Orthopedic Journal of China
基金
江苏大学博士创新基金(编号:JDFYRC-2013027)
江苏省骨科临床医学研究中心项目(编号:BL2012004)
