经皮椎体成形术190例疗效评价.pdfVIP

· 4 · 中国骨伤2008年 1月第21卷第1期 China J Orthop＆Trauma，Jan．2008，Vo1．21，No．1 临 床 研 究 · 经皮椎体成形术1 90例疗效评价 赵刚，史相钦，郑怀亮，崔宏勋，周英杰 (洛阳正骨医院 河南省脊柱外科治疗中心，河南 洛阳 471002) 【摘要】 目的：通过大宗病例的统计分析，探讨x线透视下经皮椎体成形术治疗椎体骨质疏松性压缩骨折、椎体 血管瘤、椎体转移癌的临床疗效。方法：2002年8月至2005年8月，采用C形臂X线机透视下俯卧位经皮椎弓根椎体 穿刺190例(275个椎体，男8O例，女 110例；年龄53~91岁，平均66岁)，注射PMMA。术前、术后3个月通过视觉模 拟疼痛评分(VAS)、活动能力评分和止痛药使用评分的评定，比较改善情况。结果：190例275个椎体均手术成功，VAS 术前平均(7．8±1．4)分，术后3个月平均(2．1~0．1)分，分数下降。活动能力评分：术后 3个月平均(1．21±O-36)分。较术前 平均(2．71±O．71)分明显改善。使用止痛药评分：术后3个月平均(O．89~0．43)分，较术前平均(2．12~0．56)分明显改善 (PO．05)。结论：经皮椎体成形术为微创性手术，早期止痛效果好，术后下地时间早，避免了患者长期卧床引起的各种 并发症，且手术操作简单、治疗费用低，是治疗椎体骨质疏松性压缩骨折、椎体血管瘤、椎体转移癌的有效方法。 【关键词】骨质疏松；骨折；血管瘤；转移癌；椎体 Evaluation ofpercutaneous vertebroplasty of190 cases ZHA0 Gang，SHIXiang-qin，ZHENG Huai·liang，CUIHong-xun， ZHOU Ying-jie．Luoyang Traditional Chinese Orthopaedic and Tranmatology Hospital ofHenan，Luoyang 471002，Henan， China ABSTRACT Objective：To evaluate the therapeutic effect of percutaneous vertebroplasty(PVP)guided by X—ray fluo— roscopy in treating osteoporotic spinal compression fractures，hemangioma of vertebra and metastatic carcinoma of vertebra． Methods：One hundred and ninety patients with 275 diseased vertebra underwent PVP under the guidance of C-arm fluo·- roscopy(male 8O，female 110，ranging in age from 53 to 91 years，with an average of 66 years)．Bone marrow biopsy needle was inserted percutaneously via transpedicular way into the diseased vertebra．Polymethylmethacrylate(PMMA)was then injected into the diseased vertebra．Visual analogue scale(VAS)，mobility and analgesic usage were evaluated pre-operation and 3 months after PVP．Results：PVP was successful in 190 cases(275 vertebrae)．VAS was tested by t test at 3 months af- ter PVP(P0．05)．Simultaneously，scale of pafient~mobility and scale of analgesic usage was tested by rank sum test at 3 months after PVP(PO