摘要
目的 对比单侧与双侧经皮椎体后凸成形术(PKP)对骨质疏松性胸腰椎压缩性骨折患者血清骨钙素(BGP)、碱性磷酸酶(ALP)、骨保护素(OPG)、I型胶原交联羧基末端肽(CTX-I)的影响.方法 回顾性分析南京医科大学附属逸夫医院于2016年7月至2019年8月收治的骨质疏松性胸腰椎压缩性骨折患者60例,根据手术方案的不同分为对照组与观察组,各30例.对照组进行双侧PKP,观察组进行单侧PKP.比较2组手术中情况、手术前和手术后3d相关指标变化及血清骨代谢情况、并发症发生率.结果 与手术前相比,手术后3?d 视觉模拟疼痛评分(VAS)评分、椎体Cobb角明显下降(P<0.05),而椎体平均高度明显升高(P<0.05),且观察组优于对照组(P<0.05);与手术前相比,手术后3?d BGP、ALP升高,OPG、CTX-I下降,且观察组优于对照组(P<0.05);与对照组相比,观察组手术时间、术中X线检查次数、骨水泥的用量明显低于对照组(P<0.05);手术后3?d,观察组的并发症发生率为6.67%,低于对照组的26.67%(P<0.05).结论 单侧 PKP术,在治疗胸腰椎骨质疏松性压缩性骨折方面具有良好的应用价值,其手术时间短,而且可以对患者术中X线检查次数、骨水泥的用量等进行控制,同时,可以减少并发症发生,对VAS评分、椎体Cobb角、椎体平均高度、BGP、ALP、OPG、CTX-I等指标也有更好的改善效果.
Objective To The effects of PKP onserum BGP,ALP,OPG and CTX-I were compared.Methods Retrospective analysis was performed on 60 patients with osteoporotic thoracolumbar compression fractures admitted to the affiliated yifu hospital of nanjing medical university from July 2016 to August 2019.According to different surgical procedures,they were divided into control group and observation group,with 30 patients in each group.Bilateral PKP was performed in the control group and unilateral PKP in the observation group.Changes in intraoperative,pre-operative and post-operative 3d indicators,serum bone metabolism and complication rates were compared between the two groups.Results Compared with that before the surgery,the 3d visual analogue pain score(VAS)and Cobb Angle of the vertebral body after the surgery significantly decreased(P<0.05),while the average vertebral height significantly increased(P<0.05),and the observation group was better than the control group(P<0.05).Compared with before surgery,3 d BGP and ALP increased,OPG and ctx-i decreased,and the observation group was better than the control group(P<0.05).Compared with the control group,the operative time,number of intraoperative X-ray examination and amount of bone cement in the observation group were significantly lower than those in the control group(P<0.05).The complication rate of the observation group was 6.67%on the 3 d after surgery,which was lower than that of the control group(P<0.05).Conclusion Unilateral PKP holds,in the treatment of thoracolumbar osteoporotic compression fractures has good application value,the operation time is short,but also to the number of patients with intraoperative X-ray,bone cement dosage control,etc.At the same time,can reduce complications,the VAS score,average vertebral Cobb Angle,vertebral body height,BGP and ALP,OPG and indexes of CTX-I also have a better improvement.
作者
耿大伟
陈思春
江龙海
覃健
GENG Dawei;CHEN Sichun;JIANG Longhai;QIAN Jian(Yifu Hospital,Nanjing Medical University,Orthopaedics,Nanjing,Jiangsu 211166,China)
出处
《大医生》
2019年第21期151-154,共4页
Doctor
