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| 止痛泵下手法复位联合经皮椎体成形术治疗老年骨质疏松性压缩骨折 |
| Manual reduction combined with percutaneous vertebroplasty under intravenous analgesic pump for the treatment of senile osteoporotic vertebral compression fractures |
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| DOI：10. 3969/j. issn. 1006-7108. 2012. 12. 013 |
| 中文关键词: 经皮椎体成形术 骨质疏松 椎体压缩骨折 镇痛泵 |
| 英文关键词:Percutaneous vertebroplasty Osteoporosis Vertebral compression fractures Patient controlled intravenous analgesia |
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| 中文摘要: |
| 目的 探讨止痛泵下手法复位联合经皮椎体成形术（PVP)治疗老年骨质疏松性压缩骨折的临 床效果及并发症。方法 自2008年8月至2011年9月，74例骨质疏松性压缩骨折患者在C型臂下行手法复位后马上行经皮椎体成形术，整个操作过程患者带自控镇痛泵。所有患者均在术后行X线检查以评价骨水泥填充情况及有无渗漏。疗效判定采用视觉模拟评分（visual analogue scale, VAS )， 对患者术前、术后疼痛情况进行分级比较，观察手术并发症，以及Cobb角、椎体前缘高度改善情况。 结果 手术成功率高，术后患者疼痛明显减轻或消失，17例出现骨水泥的渗漏，有6例出现穿刺部位疼痛，X线检查骨水泥充填良好，骨折复位满意，术后Cobb角及椎体前缘高度均显著改善。74例患 者平均随访19个月，疼痛未见加重，仅2个椎体高度出现少量丢失，2例患者邻近椎体发生骨折，再 次行经皮椎体成形术。结论 止痛泵下手法复位联合PVP治疗骨质疏松性压缩性骨折疗效好，整个治疗过程痛苦小，可在短时间内解除患者痛苦。 |
| 英文摘要: |
| Objective To investigate the clinical effect and complacations of manual reduction combined with percutaneous vertebroplasty ( PVP ) under intravenous analgesic pump for the treatment of senile osteoporotic vertebral compression fractures. Methods From August 2008 to September 2011,a total of 74 patients with osteoporotic vertebral compression fractures received percutaneous vertebroplasty immediately after manual reduction under C-type arm. Self-controlled analgesic pump was used during the whole process. All the patients recieved X-ray examination to evaluate the filling of bone cement and the presence of leakage. Visual analogue scale ( VAS ) was used to investigate the effect of the treatment. Pain of both pre-and psot-operation was classified and compared. Complications of the operation，the improvement of Cobb’s angle, and height of the vertebral front edge were observed. Results The success rate of the operation was high. Pain was obviously relieved or disappeared after the operation. Seventeen patients suffered from cement leakage. Six patients suffered from pain in puncture area. X-ray examination showed good filling of the bone cement. The reduction of fractures was satisfied. The improvement of Cobb’ s angle and the height of vertebral front edge was significant. The mean follow-up of the 74 patients was 19 months. No case of pain aggravation was reported. Two patients had a little loss of vertebral body height. Two patients had adjacent vertebral fractures and received a second PVP. Conclusion Manual reduction combined with PVP under self-controlled analgesic pump for the treatment of senile osteoporotic vertebral compression fractures has a good effect. The pain in the whole course of the treatment is little，and the pain can he relieved in a short time. |
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