摘要
目的:探究经皮椎体成形术单侧穿刺入路在骨质疏松性椎体压缩骨折中的效果及对创伤反应的影响。方法:将2019年1月-2021年10月广元市第一人民医院收治的103例骨质疏松性椎体压缩骨折患者根据随机数字表法分为对照组(n=51)和观察组(n=52)。观察组采用单侧穿刺入路经皮椎体成形术治疗,对照组进行双侧穿刺入路经皮椎体成形术治疗。比较两组的手术时间、术中骨水泥渗漏率、X线应用次数、手术前后的Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)评分、椎体参数及创伤应激指标[血清促肾上腺皮质激素(ACTH)、皮质醇(Cor)及前列腺素E_(2)(PGE_(2))]。结果:观察组手术时间显著短于对照组,X线应用次数显著少于对照组(P<0.05),两组术中骨水泥渗漏率比较,差异无统计学意义(P>0.05);术前两组ODI、VAS评分、椎体参数及创伤应激指标比较,差异均无统计学意义(P>0.05);术后1周及6个月,两组ODI、VAS评分、椎体参数均较术前显著改善(P<0.05),但两组比较,差异均无统计学意义(P>0.05);术后5 d,观察组的创伤应激指标均显著低于对照组(P<0.05)。结论:单侧穿刺入路其在腰椎功能及疼痛程度改善方面与双侧穿刺入路无显著差异,但其缩短手术时间、减少X线应用次数及减轻创伤反应的作用相对更好,因此单侧穿刺入路在骨质疏松性椎体压缩骨折经皮椎体成形术中的应用价值相对更高。
Objective:To investigate the effect of percutaneous vertebroplasty with unilateral puncture approach in osteoporotic vertebral compression fracture and its impact on traumatic response.Method:A total of 103 patients with osteoporotic vertebral compression fractures who were admitted to the First People's Hospital of Guangyuan from January 2019 to October 2021 were divided into the control group(n=51)and the observation group(n=52)according to the random number table method.The observation group was treated with percutaneous vertebroplasty with unilateral puncture approach,and the control group was treated with percutaneous vertebroplasty with bilateral puncture approach.The operation time,intraoperative bone cement leakage rate,X-ray application times,the Oswestry dysfunction index(ODI),visual analogue scale(VAS)scores,vertebral body parameters and trauma stress indexes[serum adrenocorticotropic hormone(ACTH),cortisol(Cor)and prostaglandin E 2(PGE 2)]before and after operation were compared between the two groups.Result:The operation time of the observation group was significantly shorter than that of the control group,and the X-ray applications times was significantly less than that of the control group(P<0.05).There was no significant difference in the rate of intraoperative bone cement leakage between the two groups(P>0.05).There were no significant differences in ODI,VAS scores,vertebral body parameters and trauma stress indexes between the two groups before operation(P>0.05).1 week and 6 months after operation,ODI,VAS scores and vertebral body parameters in the two groups were significantly improved compared with those before operation(P<0.05),but there were no significant differences between the two groups(P>0.05).5 d after operation,the indexes of traumatic stress in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:There are no significant differences between unilateral puncture approach and bilateral puncture approach in improving lumbar function and pain degree,but it has a better effect in shortening operation time,reducing X-ray application times and reducing traumatic response,so the application value of unilateral puncture approach in percutaneous vertebroplasty of osteoporotic vertebral compression fracture is relatively higher.
作者
乔俊
李刚
李松
张军
谈中文
陈川
QIAO Jun;LI Gang;LI Song;ZHANG Jun;TAN Zhongwen;CHEN Chuan(The First People's Hospital of Guangyuan,Sichuan Province,Guangyuan 628017,China)
出处
《中国医学创新》
CAS
2023年第9期14-18,共5页
Medical Innovation of China
关键词
骨质疏松性椎体压缩骨折
经皮椎体成形术
单侧穿刺入路
创伤反应
Osteoporotic vertebral compression fracture
Percutaneous vertebroplasty
Unilateral puncture approach
Traumatic response
