张朗仪??易伦??胡金华

[摘要] 目的 经皮椎体后凸成形术治疗胸腰椎骨质疏松性压缩骨折疗效观察。 方法 选取我院2014年1月～2016年1月共40例胸腰椎骨质疏松性压缩骨折患者，随机分为甲乙两组各20例。其中甲组将骨水泥通过疼痛侧椎弓根准确灌注在MR提示的水肿区，不超过中线；乙组则通过疼痛侧椎弓根将骨水泥准确灌注在病椎中间，骨水泥以中线为主，并弥散在椎体的双侧，则为手术成功。 结果 甲组患者VAS评分、ODI指数与乙组患者相比无统计学差异（P>0.05）；乙组患者Cobbs角、SI指数低于甲组，差异有统计学意义（P<0.05）。 结论 从比较疼痛侧的椎弓根进入，准确将骨水泥灌注在椎体中间的MR提示椎体上或下的水肿影区域，患者病椎强度恢复较为均衡，且骨水泥发热灭活椎体内的神经较为完全，故疼痛缓解较明显，可明显提高手术治疗效果。

[关键词] 经皮椎体后凸成形术；胸腰椎骨质疏松性；压缩骨折

[中图分类号] R6870.3 [文献标识码] A [文章编号] 2095-0616（2017）12-172-04

Clinical efficacy of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

ZHANG Langyi YI Lun HU Jinhua

Wengyuan County People's Hospital， Guangdong， Wengyuan 512600， China

[Abstract] Objective To observe the clinical efficacy of percutaneous kyphoplasty for osteoporotic vertebral compression fractures. Methods A total of 40 patients with osteoporosis fracture fracture from Jan 2014 to Jan 2016 were selected and randomly divided into group A and group B， each of 20 cases. Group A underwent bone cement accurate perfusion in the edematous region of MR presentation through the painful lateral pedicle； Group B underwent bone cement accurate perfusion in the middle of the affected vertebra through the painful lateral pedicle， and diffused bilaterally in the vertebral body， and the operation was successful. Results The VAS score and ODI index were not statistically significant between two groups （P>0.05）. The Cobb's angles and SI index of group B were lower than those of the group A， and the difference was statistically significant （P<0.05）. Conclusion Strength recovery of affected vertebra in patients with bone cement accurate perfusion in the edematous region of MR presentation through the painful lateral pedicle is equilibrium， and inactivation of vertebral nerve by bone cement generating heat is more complete， so the pain relief is more obvious， and clinical efficacy is improved.

[Key words] Percutaneous kyphoplasty； Thoracolumbar vertebral osteoporosis； Compression fracture

椎体骨质疏松性压缩骨折多发于老年人群，临床中大多采用长期卧床、支具固定以及药物治疗等常规方式进行治疗，但这些治疗方式的疗效不明显。同时，长期卧床还可能导致患者出现循环、呼吸等并发症，甚至威胁到患者的生命安全。经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）是一项安全、有效的且并发症极低的手术，现在我国各大医院已得到积极推广[1-3]。但通过笔者对本院手术的40例患者随机分成各20例患者的甲乙两个对照组对照治疗观察，发现骨水泥灌注部位对患者疼痛缓解的疗效有明显的影响。

1 资料与方法

1.1 一般资料

选取我院2014年1月～2016年1月共40例胸腰椎骨质疏松性压缩骨折患者作为研究对象，随机分为甲乙两组各20例。甲组中男8例，女12例，年龄62～92岁，平均年龄（75.1±8.4）岁；乙组中男9例，女11例，年龄63～91岁，平均（76.9±8.9）岁。本……