老年骨质疏松性脊柱骨折患者应用经皮椎体成形术的治疗效果分析

代德勇

[摘要] 目的 探討老年骨质疏松性脊柱骨折患者应用经皮椎体成形术的治疗效果。 方法 方便选择该院2017年3月—2019年4月收治的98例老年骨质疏松性脊柱骨折患者为研究对象，按照不同手术方式分为试验组与参照组。试验组患者实施经皮椎体成形术治疗，参照组患者实施短节段椎弓根钉内固定术治疗。观察与比较两组患者术后后凸 Cobb 角、伤椎前缘高度、伤椎后缘高度、疼痛评分、日常生活能力评分以及治疗总有效率。 结果 试验组术后后凸Cobb角角度，伤椎前缘高度、伤椎后缘高度明显优于参照组，差异有统计学意义（t=3.964、4.067、4.182，P<0.05）;试验组术后VAS、Barthel评分明显优于对照组，差异有统计学意义（t=4.306、4.162，P<0.05），试验组治疗总有效率95.92%明显高于对照组79.59%，差异有统计学意义（χ2=5.303，P<0.05）。 结论 对老年骨质疏松性脊柱骨折患者应用经皮椎体成形术治疗疗效更为确切，患者术后疼痛程度较轻，对患者日常生活影响较小，值得应用。

[关键词] 骨质疏松性脊柱骨折;经皮椎体成形术;短节段椎弓根钉内固定;治疗效果

[中图分类号] R816.8          [文献标识码] A          [文章编号] 1674-0742（2020）10（a）-0042-03

Analysis of the Therapeutic Effect of Percutaneous Vertebroplasty in Elderly Patients with Osteoporotic Spine Fractures

DAI De-yong

Department of Orthopedics， Guanxian People's Hospital， Guanxian， Shandong Province， 252500 China

[Abstract] Objective To investigate the therapeutic effect of percutaneous vertebroplasty in elderly patients with osteoporotic spine fractures. Methods A total of 98 elderly patients with osteoporotic spine fractures who were admitted to the hospital from March 2017 to April 2019 were convenient selected as the subjects of this study and divided into experimental group and reference group according to different surgical methods. Patients in the experimental group were treated with percutaneous vertebroplasty， and patients in the reference group were treated with short-segment pedicle screw internal fixation. The postoperative kyphotic Cobb angle， the height of the anterior edge of the injured vertebra， the height of the posterior edge of the injured vertebra， the pain score， the ability of daily living score and the total effective rate of treatment were observed and compared between the two groups. Results The experimental groups postoperative kyphotic Cobb angle， the height of the anterior edge of the injured vertebra， and the height of the posterior edge of the injured vertebrae were significantly better than those of the reference group， the difference was statistically significant（t=3.964，4.067，4.182， P<0.05）; VAS and Barthel scores were significantly better than those of the control group， and the differences were statistically significant （t=4.306， 4.162， P<0.05）. The total effective rate of treatment in the experimental group was 95.92% significantly higher than that of the control group 79.59%， and the differences were statistically significant（χ2=5.303，P<0.05）. Conclusion Percutaneous vertebroplasty is more effective in the treatment of elderly patients with osteoporotic spine fractures. The postoperative pain of the patients is less and it has less impact on the patients' daily life. It is worthy of application.

经皮椎体成形术是一种微创手术，其已经被广泛的应用于椎体骨折临床治疗中。经皮椎体成形术通过向骨折部位椎体内注入骨水泥等材料，增强骨折部位椎体的高度与强度，使受损椎体更加稳定。既往研究表明[8]，经皮椎体成形术能够明显增强骨质的强度，能够降低患者术后长期卧床可能出现的压疮等并发症的几率，有利于避免病变椎体进一步塌陷。同时，经皮椎体成形术可以有效恢复患者椎体生物力学性能，同时也可以使脊髓神经根部分减压，可达到减轻疼痛的效果。

该文研究结果显示，试验组术后后凸Cobb角角度（8.92±1.74）°低于参照组（13.04±1.61）°，伤椎前缘高度（83.27±2.46）%、伤椎后缘高度（82.69±5.11）%明显高于参照组（76.05±2.52）%、（76.87±5.04）%（P<0.05）;试验组术后VAS评分为（1.29±0.83）分、Barthel评分为（88.23±3.42）分明显优于对照组（3.05±0.74）分、（72.11±3.37）分（P<0.05），试验组治疗总有效率95.92%明显高于对照组79.59%（P<0.05）。上述结果与王自刚等人[9]研究结果：手术组治疗总有效率95%明显高于保守組78%（P<0.05），基本一致。

综上所述，对老年骨质疏松性脊柱骨折患者应用经皮椎体成形术治疗疗效更为确切，患者术后疼痛程度较轻，对患者日常生活影响较小。

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（收稿日期：2020-07-04）