摘要
目的探讨经皮椎体后凸成形术（pereutanous kyphoplasty,PKP）后非手术椎体再发骨折的相关危险因素。方法选取2011年1月至2014年12月本院骨科收治的胸腰段压缩性骨折并行PKP治疗的105例患者为研究对象。根据术后是否发生非手术节段椎体骨折将其分为骨折组与非骨折组,对比分析两组患者的年龄、性别、骨折节段、骨水泥注入量、骨水泥外渗情况、术前原椎体后凸Cobb角、术后骨折椎体后凸Cobb角、骨折椎体后凸Cobb角纠正角度以及是否进行抗骨质疏松治疗与补肾活血中药治疗。结果 105例行PKP治疗的胸腰段压缩性骨折患者术后非手术椎体再发骨折16例,发生率为15.2%;再发骨折时间为术后1~45个月,平均再发骨折时间为术后（15.6±7.8）个月;其中邻近椎体再发骨折8例（50.0%）,远隔椎体再发骨折6例（37.5%）,两处同时再发骨折2例（12.5%）。多因素Logistic回归分析发现,PKP后非手术椎体再发骨折的危险因素为骨水泥外渗（OR=4.727,P=0.048）、骨折椎体后凸Cobb角纠正角度较高（OR=5.040,P=0.042）,保护因素为抗骨质疏松治疗（OR=0.181,P=0.030）、补肾活血中药治疗（OR=0.188,P=0.033）。结论临床手术过程中应避免骨水泥外渗的发生,伤椎局部后凸角的纠正角度不宜过高,并重视围术期抗骨质疏松药物及补肾活血中药的应用。
Objective To analyze the risk factor of non-surgical vertebral centrum recurrence fracture after pereutanous kyphoplasty（PKP）. Method 105 patients with thoracolumbar vertebral compression fracture after PKP from January 2011 to December 2011 in our hospital were selected as the research objects, they were divided into fracture group and non-fracture group according to whether the postoperative nonsurgical segmental centrum fracture. The age, sex, fracture segment, bone cement injection, bone cement leakage, preoperative vertebral bodies of the protruding after Cobb angle, postoperative fracture vertebral body protruding after Cobb angle, vertebral body fracture of the protruding after Cobb angle correction angle and anti-osteoporosis treatment, Chinese herbs treatment between the two groups were compared. ResultThe rate of non-surgical vertebral recurrence fracture after PKP was 15.2%（16/105）. The average recurrence time was（15.6±7.8） months（1 ~ 45 months）, and the rate of fracture in adjacent vertebra was 50.0%, the rate of fracture in apart vertebra was 37.5%. The risk factor of non-surgical vertebral recurrence fracture after PKP were bone cement leakage（OR = 4.727, P = 0.048）, fracture vertebral body protruding after Cobb angle correction angle（OR = 5.040, P = 0.042）, and protective factors were anti-osteoporosis treatment（OR = 0.181, P = 0.030） and Chinese herbs treatment（OR = 0.188, P = 0.033）. Conclusion Bone cement leakage should be avoided in the process of clinical surgery and the correction angle of injured vertebra locally convex should not be too high. The anti osteoporosis drug perioperative and the traditional Chinese medicine can be used.
出处
《中国医学前沿杂志（电子版）》
2016年第3期75-78,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
经皮椎体后凸成形术
非手术椎体
再发骨折
危险因素
Pereutanous kyphoplasty
Non-surgical vertebral centrum
Recurrence fracture
Risk factors
作者简介
通讯作者：吴铮E-mail：wangrneirong001@126．com
