摘要
目的探讨骨水泥灌注剂量和弥散情况对单侧PKP术后早期镇痛效果的影响。方法纳入59例行单侧PKP手术治疗的骨质疏松性椎体压缩骨折患者,术后第3天评估其腰背痛VAS评分的改善率,并采用Spearman秩相关系数对术中骨水泥剂量和骨水泥弥散指数与VAS改善率的相关性进行分析。结果59例患者均完成PKP手术,术中骨水泥注入量为3~6 mL,平均(4.5±0.9)mL;弥散系数为-0.3~0.9,平均(0.51±0.28)。其中8例出现骨水泥渗漏、发生率13.6%。渗漏组的骨水泥剂量显著高于未渗漏组,差异有统计学意义(P<0.05);但两组的弥散指数和VAS改善率差异均无统计学意义(P>0.05)。经Spearman秩相关分析,骨水泥剂量与患者术后VAS改善率之间并无明显相关性(r=0.13;P>0.05);而骨水泥弥散指数与术后VAS改善率之间呈现强相关性(r=0.85;P<0.05)。结论单侧PKP术中骨水泥剂量对其术后早期镇痛效果无明显影响,但术中骨水泥在伤椎两侧的弥散越均衡则镇痛效果越好。
Objective To investigate the effects of bone cement infusion dose and bone cement dispersion in injured vertebra on the early analgesic effect of unilateral PKP after operation.Methods Fifty-nine cases of osteoporotic vertebral compression fracture treated by unilateral PKP were included.The improvement rate of VAS score of lumbago and backache was evaluated on the third day after operation.The correlation between the amount of bone cement and the diffusion index of bone cement and the improvement rate of VAS was analyzed by Spearman rank correlation coefficient.Results All the 59 patients completed PKP operation.During the operation,the amount of bone cement was 3-6 mL,the average was(4.5±0.9)mL.The diffusion coefficient was-0.3~0.9,the average was(0.51±0.28).The leakage rate of bone cement was 13.6%.The dosage of bone cement in leakage group was significantly higher than that in non-leakage group(P<0.05),but there were no significant differences in diffusion index and VAS improvement rate between the two groups(P>0.05).According to Spearman rank correlation analysis,there was no significant correlation between the dosage of bone cement and the improvement rate of VAS(r=0.13;P>0.05),while there was a strong correlation between the diffusion index of bone cement and the improvement rate of VAS(r=0.85;P<0.05).Conclusion The amount of bone cement used in PKP has no significant effect on the early postoperative analgesia,but the more balanced the diffusion of bone cement on both sides of the injured vertebra,the better the analgesic effect.
作者
王丰耀
李家驹
郭宏宇
鲁学良
熊明月
WANG Feng-yao;LI Jia-ju;GUO Hong-yu;LU Xue-liang;XIONG Ming-yue(Department of Traumatology,New District Hospital,the First Hospital Affiliated to Henan University of Science and Technology,Luoyang,Henan,471000,China)
出处
《颈腰痛杂志》
2020年第6期684-688,共5页
The Journal of Cervicodynia and Lumbodynia
基金
宁夏回族自治区自然科学基金(编号:NZ16212)。
关键词
骨质疏松性椎体压缩骨折
PKP手术
骨水泥
弥散指数
osteoporotic vertebral compression fracture
PKP operation
bone cement
diffusion index
