黄明智 庄勇 尚显文 陈红艳

【摘要】 目的 探讨经皮球囊扩张椎体后凸成形术（PKP）和经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩骨折的临床疗效。方法 将收治的64例骨质疏松性椎体压缩骨折患者按照术式不同分为两组，观察组34例行PKP治疗，对照组30例行PVP治疗。观察两组患者术前术后的VAS评分、椎体高度与椎体后凸Cobb角。结果 治疗前，两组的VAS评分比较差异无统计学意义（P>0.05）；术后1个月及1年两组的VAS评分均显著降低（P<0.01），观察组的VAS评分降低更明显（P<0.01）。 治疗前，两组的椎体高度、椎体后凸Cobb角比较差异无统计学意义（P>0.05）；术后1个月及1年观察组的椎体高度、椎体后凸Cobb角均显著改善（P<0.01），且改善程度优于对照组（P<0.01）。结论 骨质疏松性椎体压缩骨折患者近期疼痛在运用PKP和PVP治疗后均可得到有效缓解，但PKP在恢复患者椎体高度、矫正后凸畸形及缓解远期疼痛方面较PVP更有优势。

【关键词】 PKP；PVP；骨质疏松；椎体压缩骨折

中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1003-1383.2018.03.008

【Abstract】 Objective To investigate the clinical effects of percutaneous balloon kyphoplasty （PKP） and percutaneous vertebroplasty （PVP） on osteoporotic vertebral compression fractures.Methods The clinical data of 64 patients with osteoporotic vertebral compression fractures admitted in our hospital were retrospectively analyzed.According to different surgical procedures，they were divided into observation group and control group.PKP was treated in 34 cases in the observation group and PVP in 30 cases in the control group.And then，VAS score，vertebral height and kyphosis Cobb angle were observed before and after operation in both groups.Results Before treatment，there was no statistically significant difference in VAS score between the two groups （P>0.05）.1 month and 1 year after operation，however，the VAS scores in both groups all significantly decreased（P<0.01），and the VAS score in the observation group decreased more significantly（P<0.01）.Before treatment，difference of vertebral height and kyphosis Cobb angle between the two groups was not statistically significant （P>0.05）.1 month and 1 year after operation，the vertebral height and the kyphosis Cobb angle in the observation group significantly improved（P<0.01），and the degree of improvement was better than that of the control group（P<0.01）.Conclusion Short-term pain in patients with osteoporotic vertebral compression fractures can be effectively alleviated after PKP and PVP treatment.However，PKP has more advantages than PVP in restoring vertebral height，correcting kyphosis and relieving long-term pain.

【Key words】 PKP；PVP；osteoporosis；vertebral compression fractures

經皮球囊扩张椎体后凸成形术（PKP）和经皮椎体成形术（PVP）是有效治疗骨质疏松性椎体压缩骨折的微创术式，但两种手术方式对骨质疏松性椎体压缩骨折的治疗效果不尽相同[1]。笔者对比观察两种手术方式的治疗效果，以期为骨质疏松性椎体压缩骨折临床治疗最佳方案的选择提供借鉴，现报告如下。

1 资料与方法

1.1 一般资料

将2015年9月～2016年9月进入我院脊柱外科接受治疗的64例骨质疏松性椎体压缩骨折患者分为观察组与对照组，对照组30例，其中男性18例，女性12例；平均年龄（64.61±1.37）岁；伤椎部位在T10的有5个，T11的有14个，T12的有20个，L1有24个，L2有12个，L3有4个。观察组34例，其中男性21例，女性13例；平均年龄（64.48±1.31）岁；伤椎部位在T10的有7个，T11的有16个，T12的有21个，L1有27个，L2有13个，L3有6个。两组性别、年龄、伤椎部位等比较差异无统计学意义（P>0.05），具有可比性。

1.2 纳入与排除标准

纳入标准：①所有入选患者均经临床诊断被确诊为骨质疏松性椎体压缩骨折，其中，影像学结果显示其椎体骨质不连续，骨折仅累及椎体前柱，脊椎稳定性无破坏；②……