摘要
目的探讨肌少症对经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)手术疗效的影响。方法回顾性分析广东省第二中医院骨科2020年6月至2022年6月通过PVP治疗90例入组的OVCF患者。采用电子握力器测量优势手的握力,利用PACS软件扫描CT/MRI横截面图像,测量计算胸12椎体椎弓根水平面肌肉组织的横截面积(cm^(2)),肌肉横截面积除以身高的平方计算得到骨骼肌质量指数(skeletal muscle mass index,SMI)。根据亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)标准,握力和SMI同时符合诊断标准的患者入组肌少症组,其他的患者入组非肌少症组。两组患者均已经接受PVP手术治疗OVCF,比较两组的年龄、性别、体质量、手术时间、出血量、术前视觉模拟评分(visual analogue scale,VAS)、术后1周VAS、离床下地行走时间、住院时间。结果肌少症组患者平均年龄大于非肌少症组(t=3.512,P<0.001);肌少症组女性占比多过非肌少症组(χ^(2)=2.078,P<0.001);肌少症组患者平均体质量小于非肌少症组(t=1.613,P<0.001);肌少症组患者术后下地时间长于非肌少症组(t=3.849,P<0.001);肌少症组住院时间长于非肌少症组(t=4.993,P<0.001);肌少症组患者术后1周VAS评分低于非肌少症组(Z=-4.687,P<0.001)。结论肌少症组患者年龄偏大,女性居多,体质量偏低,手术后恢复时间偏长,需要重点关注该类患者的药物治疗、饮食调理和功能锻炼。
Objective To investigate the effects of sarcopenia on the efficacy of percutaneous vertebroplasty(PVP)in the patients with osteoporotic vertebral compression fractures(OVCF).Methods Retrospective analysed 90 patients enrolled in OVCF through PVP from June 2020 to June 2022 in the Department of Orthopedics of Guangdong Second Hospital of Traditional Chinese Medicine.The electronic grip device was used to measure the grip force of the dominant hand,and the CT/MRI cross-sectional image was scanned by PACS software,and the cross-sectional area(cm^(2))of the horizontal surface of the pedicle of the thoracic 12 vertebral body was measured and calculated,and the muscle cross-sectional area was divided by the square of the height to obtain the skeletal muscle index(SMI).According to Asian Working Group for Sarcopenia(AWGS),patients with both low grip strength and SMI were enrolled in the sarcopenia group,and other patients were enrolled in the non-sarcopenia group.Both groups of patients had undergone PVP surgery for OVCF,and the age,sex,weight,duration of surgery,amount of bleeding,preoperative visual analogue scale(VAS),VAS of one week after surgery,time of walking off the bed,and length of hospital stay were compared between the two groups.Results The average age of patients in the sarcopenia group was greater than that in the non sarcopenia group(t=3.512,P<0.001);The proportion of women in the sarcopenia group is higher than that in the non sarcopenia group(χ^(2)=2.078,P<0.001);The average body mass of patients with sarcopenia was lower than that of non sarcopenia group(t=1.613,P<0.001;Patients in the sarcopenia group had a longer postoperative time in the ground than those in the non sarcopenia group(t=3.849,P<0.001);The hospitalization time in the sarcopenia group is longer than that in the non sarcopenia group(t=4.993,P<0.001);The VAS score of patients in the sarcopenia group was lower than that in the non sarcopenia group one week after surgery(Z=-4.687,P<0.001).Conclusion Patients in the sarcopenia group are older,with more female,lower weight,who have a long recovery time after surgery,so they need to focus on drug treatment,dietary conditioning,and functional exercise.
作者
董云鹏
李伟举
胡青松
吕朝晖
DONG Yun-peng;LI Wei-ju;HU Qing-song;LYU Zhao-hui(Department of Orthopedics,The Fifth School of Clinical Medical Sciences of Guangzhou University of Chinese Medicine(Guangdong Second Traditional Chinese Medicine Hospital),Guangzhou 510095,China;Department of Orthopedics,The Second School of Clinical Medical Sciences of Guangzhou University of Chinese Medicine,Guagnzhou,510405,China)
出处
《中华骨质疏松和骨矿盐疾病杂志》
CSCD
北大核心
2023年第3期230-235,共6页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
全国老中医药专家学术经验继承项目(国中医药人教函[2022]76号)
广州市科技计划项目(202102080119)。
