摘要
目的探讨有限切开经椎弓根外入路经皮椎体后凸成形术(PKP)治疗中段胸椎骨质疏松性椎体压缩性骨折(OVCF)的临床疗效.方法选取于2018年1月—2021年12月我院收治的82例中段胸椎OVCF患者为研究对象,按随机数字表法分为对照组、观察组,每组41例.对照组采用经皮椎体成形术,观察组采用有限切开经椎弓根外入路PKP.对两组手术相关指标、临床疗效、术前与术后48 h炎性因子水平、并发症进行分析和对比.结果观察组手术时间、住院时间均较对照组更短,术中出血量较对照组更多,术中透视次数较对照组更少,术后3d疼痛视觉模拟评分较对照组更低,组间差异有统计学意义(P<0.05).术前,两组Oswestry功能障碍指数问卷表(ODI)评分、伤椎前缘高度、伤椎Cobb角对比,组间差异无统计学意义(P>0.05);术后3个月,相较于对照组,观察组ODI评分更低,伤椎前缘高度更高,伤椎Cobb角更小,组间差异有统计学意义(P<0.05).术前,两组C反应蛋白(CRP)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)水平对比,组间差异无统计学意义(P>0.05);术后48 h,观察组CRP、IL-1、IL-6水平均低于对照组,组间差异有统计学意义(P<0.05).观察组并发症发生率为12.20%,与对照组的14.63%比较,差异无统计学意义(P>0.05).结论有限切开经椎弓根外入路PKP治疗中段胸椎OVCF的疗效显著,具有手术时间短、术中透视次数少、恢复快、疼痛缓解明显等优点,且术后炎症反应较轻,安全性较高,值得临床推广.
Objective To investigate the clinical efficacy of limited incision transpedicular lateral approach percutaneous kyphoplasty(PKP)in the treatment of osteoporosis vertebral compression fracture(OVCF)in the middle section of the thoracic vertebra.Methods 82 patients with OVCF in the middle section of the thoracic vertebra admitted to the hospital from January 2018 to December 2021 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 41 cases in each group.The control group received percutaneous vertebroplasty,and the observation group received limited incision transpedicular lateral approach PKP.The operation-related indexes,clinical efficacy,levels of inflammatory factors before surgery and 48 h after surgery,and complications of the two groups were analyzed and compared.Results The operation time and hospital stay of the observation group were shorter than those of the control group,the intraoperative blood loss was more than that in the control group,and the intraoperative fluoroscopy times was less than that in the control group,the visual analogue scale score of the observation group 3 days after surgery was lower than that of the control group,and the differences between the groups were statistically significant(P<0.05).Before surgery,the Oswestry disability index(ODI)score,the height of the anterior edge of the injured vertebra and the Cobb Angle of the injured vertebra were compared between the two groups,and there were no statistically significant differences between the two groups(P>0.05);3 months after surgery,compared with the control group,the ODI score of the observation group was lower,the height of the anterior edge of the injured vertebra was higher,and the Cobb Angle of the injured vertebra was smaller,and the differences between the groups were statistically significant(P<0.05).Before surgery,there was no significant difference in the levels of C-reactive protein(CRP),interleukin-1(IL-1)and interleukin-6(IL-6)between the two groups(P>0.05);48 h after surgery,the levels of CRP,IL-1 and IL-6 in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 12.20%,compared with 14.63%in the control group,the difference was not statistically significant(P>0.05).Conclusion The limited incision transpedicular lateral approach PKP in the treatment of OVCF in the middle section of the thoracic vertebra has significant efficacy,with short operation time,fewer intraoperative fluoroscopy times,rapid recovery,obvious pain relief and other advantages,and postoperative inflammation reaction is light,and the safety is high,worthy of clinical promotion,it is worthy of clinical promotion.
作者
葛曙光
张文玺
GE Shuguang;ZHANG Wenxi(Liyang People's hospital(Liyang Branch of Jiangsu Provincial People's Hospital),Liyang Jiangsu,213300,China)
出处
《反射疗法与康复医学》
2022年第21期101-105,109,共6页
Reflexology And Rehabilitation Medicine
基金
2019年常州市卫生健康委重大科技项目(ZD201927).
关键词
中段胸椎
骨质疏松性椎体压缩性骨折
有限切开
经椎弓根外入路经皮椎体后凸成形术
炎性因子
疗效
Middle section of the thoracic vertebra
Osteoporosis vertebral compression fracture
Limited incision
Transpedicular lateral approach percutaneous kyphoplasty
Inflammatory factors
Curative effect
作者简介
葛曙光(1983-),男,江苏溧阳人,本科,主治医师,研究方向:创伤骨科临床.
