| 经皮椎体成形术治疗以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩性骨折 |
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投稿时间：2021-10-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 林昱 |
LIN Yu |
福建医科大学附属协和医院骨科, 福建 福州 350001 |
Department of Orthopaedics, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, Fujian, China |
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| 刘文革 |
LIU Wen-ge |
福建医科大学附属协和医院骨科, 福建 福州 350001 |
Department of Orthopaedics, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, Fujian, China |
738603705@qq.com |
| 王振宇 |
WANG Zhen-yu |
福建医科大学附属协和医院骨科, 福建 福州 350001 |
Department of Orthopaedics, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, Fujian, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第5期，第418-422页 |
| DOI：10.12200/j.issn.1003-0034.2022.05.003 |
| 基金项目: |
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中文摘要:
目的:分析经皮椎体成形术对以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩性骨折的疗效。
方法:回顾性分析2015年1月至2021年1月就诊的37例骨质疏松性椎体压缩性骨折患者,患者均以脊柱源性腹痛为主要症状,根据治疗方法不同分为手术组(21例)和保守组(16例)。手术组患者采用经皮椎体成形术治疗,男7例,女14例,年龄(75.95±6.84)岁,病程(5.26±3.79) d。保守组患者采用非手术治疗,男5例,女11例,年龄(75.50±8.07)岁,病程(4.28±3.42) d。两组患者术前主要表现为腹痛、腹胀或便秘,均无明显胸腰背部疼痛症状,经胸腰椎MRI确诊为新鲜的骨质疏松性椎体压缩性骨折,术后记录其腹痛视觉模拟评分(visual analogue scale,VAS),简明健康状况调查表(medical outcomes study short form-36,SF-36)评分,治疗后排便时间等。
结果:37例患者均获得随访,随访时间手术组(14.90±14.11)个月,保守组(21.42±17.53)个月。两组患者治疗前基线资料比较差异无统计学意义(P>0.05)。相较于治疗前,手术组治疗后各时段VAS、保守组治疗后1个月VAS、两组治疗后3个月SF-36中8个维度评分均较术前明显改善(P<0.05);保守组治疗后3 d VAS与术前比较差异无统计学意义(P>0.05)。治疗前1 d 的VAS、SF-36中8个维度评分组间比较差异无统计学意义(P>0.05),治疗后3 d 的VAS、治疗后3个月生活活力及社会功能维度评分、治疗后排便时间手术组均优于保守组(P<0.05),其余指标差异无统计学意义(P>0.05)。手术组患者切口愈合良好,两组患者均无严重并发症发生。
结论:经皮椎体成形术是治疗以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩性骨折有效的方法,与保守治疗相比,在早期缓解腹痛及便秘症状、恢复生活活力及社会功能方面更有优势。 |
| 【关键词】椎体成形术 腹痛 骨质疏松 脊柱骨折 |
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| Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom |
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ABSTRACT
Objective: To analyze the efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom.
Methods: A retrospective analysis was performed on 37 patients with osteoporotic vertebral compression fractures treated from January 2015 to January 2021,all of whom had spin-derived abdominal pain as the main symptom,and were divided into surgery group(21 cases) and conservative group (16 cases) according to different treatment methods. Patients in the surgery group were treated with percutaneous vertebroplasty,including 7 males and 14 females,with an average age of (75.95±6.84) years old and an average course of disease of (5.26±3.79) days. The conservative group received non-surgical treatment,including 5 males and 11 females,with an average age of (75.50±8.07) years old and an average course of disease of (4.28±3.42) days. Two groups of patients with preoperative mainly characterized by abdominal pain,abdominal distension and constipation,have no obvious chest waist back pain symptoms,the thoracolumbar MRI diagnosed as fresh osteoporotic vertebral compression fractures,record its postoperative abdominal pain visual analogue scale (VAS),medical outcomes study short form-36 (SF-36) score,defecation interval after treatment,etc.
Results: Thirty-seven patients were followed up for (14.90±14.11) months in surgery group and(21.42±17.53) months in conservative group. Compared with before treatment,the VAS of surgery group at each time period after treatment,VAS of conservative group at 1 month after treatment and SF-36 score between two groups at 3 months after treatment were all improved(P<0.05),while VAS of conservative group at 3 days after treatment showed no statistically significant difference(P>0.05). Compared between two groups,there were no significant differences in VAS and SF-36 scores at 1 day before treatment(P>0.05),but VAS at 3 days after treatment in surgery group,life vitality and social function score at 3 months after treatment,and defecation time after treatment in surgery group were better than those in conservative group(P<0.05). There were no significant differences in other indexes(P>0.05). The incision healing of patients in surgery group was good,and no serious complications occurred in both groups.
Conclusion: Percutaneous vertebroplasty is an effective method for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom. Compared with conservative treatment,percutaneous vertebroplasty has more advantages in early relief of abdominal pain and constipation,recovery of vitality and social function. |
| KEY WORDS Vertebroplasty Abdominal pain Osteoporosis Spinal fractures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 林昱,刘文革,王振宇.经皮椎体成形术治疗以脊柱源性腹痛为主要症状的骨质疏松性椎体压缩性骨折[J].中国骨伤,2022,35(5):418~422 |
| 英文格式: | LIN Yu,LIU Wen-ge,WANG Zhen-yu.Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with spinal origin abdominal pain as the main symptom[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(5):418~422 |
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