PVP治疗老年急性椎体骨折的临床应用

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1、PVP治疗老年急性椎体骨折的临床应用作者：钱洪刚，吴鸿鹰单位：1.吉林省人民医院骨科，吉林长春130021;2.北京北亚骨科医院，北京102445【摘要】目的：探讨经皮椎体成形术(PVP)对治疗老年急性椎体件折的临床应用价值。方法:36例老年急性床缩性和粉碎性椎体骨折的患者，骨折的部位为椎体的前部或和中部，患者均不伴有神经功能障碍。选择椎体骨折相对严重的一侧注入佇水泥，竹水泥的剂量控制在2〜6ml范围内。分别在术前、术后48h记录疼痛分数和功能水平(巴塞尔指数)以评价治疗效杲。结杲：36例急性椎体骨折的患者，43

2、个佇折的椎体进行PVP治疗。术前的疼痛分数为(17.99±1.45),术后48h为(6.04±1.32),两者比较差异有统计学意义(P0.001)。巴塞尔指数术前为(54.07±16.56),术后48h为(88.12±15.98),两者比鮫差异有统计学意义(P0.001)o其中9例在骨水泥注射过程中进入椎体的两侧或前方，1例进入推间盘和椎管，2例进入静脉，1例进入肺动脉，但患者均无临床症状。结论：经皮椎体成形术是一种治疗老年急性椎体骨折的微创、安全、有效的方

3、法，能迅速缓解患者的临床症状和体征。【关键词】经皮椎体成形术;急性椎体骨折;骨水泥ClinicalapplicationofpercutaneousvertebroplastyfortreatingacutevertebralfracturesinagedpatientsQIANHong-gang1,WUHong-ying2(l.DeparmentofOrthopaedicsJilinProvincialPeople′sHospital,Changchun130021China;2.BeiyaOrth

4、opaedicsHospitalofBeijingCity,Beijing102445,China)Abstract：ObjectiveToevaluatetheefficacyandvalueofpercutaneousvertebroplasty(PVP)fortreatingacutevertebralfracturesintheagedpatients.MethodThirty-sixagedpatientswithcompressedorcomminutedvertebralfracturesunder

5、wentPVP.Thefracturesegmentsincludedtheanteriorandorthemedialpartsofthevertebralbody.Thenervousfunctionofthepatientswasnormal.Polymethylmethacrylate(PMMA)wasinjectedintothefracturedvertebraethroughtherelativelyseriousside.TheinjectiondoseofPMMArangedfrom2to6ml

6、.ThepainscoreandBarthelIndex(BI)wereevaluatedpre-PVPand48hourspost-PVPrespectively.ResultsThirty-sixcaseswith43acutevertebralfracturesunderwentPVP.Themeanvaluesofpainscorewas(17.99±1.45)beforePVP,(6.04±1.32)48hafterPVP,andtherewasstatisticallysi

7、gnificancebetweenthetwogroups(P0.001).ThemeanvaluesofBIwas(54.07±16.56)beforePVP,(88.12±15.98)48hafterPVP,andtherewasstatisticallysignificancebetweenthetwogroups(P0.()01).PerivertebralPMMAleakagewasfoundin9vertebraetleakagetotheadjacentdiscandve

8、rtebralcanalin1case,thevenousplexusin2casesandthepulmonaryarteryin1case.Allthepatientshadnotclinicalsymptoms.ConclusionPVPisaneffective,safeandmini-invasivetechniquefortreatingtheagedpati