摘要
目的:分析经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折 (osteoporotic vertebral compression fracture,OVCF)术中骨水泥渗漏的危险因素。方法:选择2017年6月至2021年6月采用PVP治疗的307例OVCF患者,从病历系统中收集患者的年龄、性别、病程、外伤史、基础疾病(高血压、糖尿病)、骨折节段、椎体骨折类型、椎体压缩程度、椎体后缘骨质是否突入椎管、椎体裂隙征、单侧或双侧穿刺、一次治疗椎体数量、单个椎体骨水泥注射量、骨水泥弥散类型、手术时间、骨水泥是否渗漏等信息。先进行单因素Logistic回归分析,再将单因素分析结果中P<0.150的变量作为自变量进行多因素Logistic回归分析。结果:307例OVCF患者共涉及371椎,其中195椎发生骨水泥渗漏、176椎未发生骨水泥渗漏。单因素Logistic回归分析结果显示,年龄(P=0.118)、基础疾病(高血压、糖尿病)(P=0.109)、骨水泥弥散类型(P=0.003)、手术时间(P=0.005)、椎体压缩程度(P=0.012)可作为多因素分析的自变量。多因素Logistic回归分析结果显示,骨水泥弥散类型为弥散型、手术时间<40min是PVP治疗OVCF术中骨水泥渗漏的独立危险因素[B=0.636,P=0.009,OR=1.899,95%CI(1.171,3.047);B=0.574,P=0.015,OR=1.776,95%CI(1.118,2.820)]。结论:手术时间<40min、骨水泥呈弥散型分布是PVP治疗OVCF术中骨水泥渗漏的独立危险因素。
Objective:To investigate the risk factors for bone cement leakage during percutaneous vertebroplasty(PVP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods:Three hundred and seven OVCF patients treated with PVP from June 2017 to June 2021 were included retrospectively.Through the medical records systems, the information of age, gender, disease course, trauma history, underlying disease(hypertension and diabetes),fracture segment, vertebral fracture type, vertebral compression degree, osteophyte protruding into vertebral canal, intravertebral cleft, puncture method(unilateral or bilateral),number of vertebral body treated at one time, amount of bone cement for single vertebral body, cement distribution type, duration of surgery, and cement leakage were collected.Univariate logistic regression analysis was performed first, and variables with a P value of<0.150 were further regarded as independent variables for multivariate logistic regression analysis.Results:The 307 OVCF cases involved 371 vertebral bodies, in which 195 vertebral bodies presented cement leakage and 176 did not.The results of univariate logistic regression showed that age(P=0.118),underlying disease(hypertension and diabetes)(P=0.109),bone cement distribution type(P=0.003),duration of surgery(P=0.005),and vertebral compression degree(P=0.012)met the requirements of being the independent variables for multivariate logistic regression analysis.The results of multivariate logistic regression analysis showed that diffuse distribution of bone cement and shortened duration of surgery(less than 40 min)were independent risk factors for bone cement leakage during PVP treatment of OVCF(B=0.636,P=0.009,OR=1.899,95% CI(1.171,3.047);B=0.574,P=0.015,OR=1.776,95% CI(1.118,2.820)).Conclusion:Shortened duration of surgery(less than 40 min)and diffuse distribution of bone cement are independent risk factors for bone cement leakage during PVP treatment of OVCF.
作者
刘锐
龚德飞
班正涛
刘汝专
黄民锋
魏纪湖
李沛桢
周华亮
LIU Rui;GONG Defei;BAN Zhengtao;LIU Ruzhuan;HUANG Minfeng;WEI Jihu;LI Peizhen;ZHOU Hualiang(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanming 530011,Guangxi,China;Graduate School of Guangxi University of Traditional Chinese Medicine,Nanning 530001,Guangxi,China)
出处
《中医正骨》
2022年第11期14-17,26,共5页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
广西壮族自治区中医药管理局自筹经费科研课题(GXZYZ20210157)。
