Kyphon球囊扩张后凸成形术并发症及对策分析.docVIP

Kyphon球囊扩张后凸成形术并发症及对策分析 　　[摘要] 目的:分析Kyphon球囊扩张后凸成形术的并发症与对策。方法:回顾性分析我院应用后凸成形术治疗38例53个骨质疏松性椎体压缩性骨折的患者,记录围术期并发症的类型,分析其原因及采用的方法。结果:38例患者53个椎体顺利完成手术,术中渗漏发生9例,其中,静脉渗漏8例,椎弓根外渗漏1例,发生突发性低血压2例,无一例死亡,无一例发生切口感染。结论:应用Kyphon球囊扩张后凸成形术手术并发症发生率较高,通过采取相应的措施可以有效降低并发症的发生率,一般不引起临床不良后果。 　　[关键词] Kyphon球囊扩张;并发症;对策 　　[中图分类号] R683.2[文献标识码]A [文章编号]1673-7210(2009)07(a)-044-03 　　 　　Analysis of complications and countermeasures of balloon kyphoplasty 　　XIAO Longyi, CHEN Zhiwei, CHEN Xunwen, GUAN Honggang 　　(Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China) 　　[Abstract] Objective: To analyze the complications and countermeasures of the balloon kyphoplasty. Methods: 38 patients with 53 osteoporotic vertebral compression fracture treated with balloon kyphoplasty were retrospectively analyzed. The type of complications of kyphoplasty was recorded, and the causes and treatments were analyzed. Results: 38 cases of patients with 53 completed vertebral surgeries were performed successfully, during the surgery time, leakage occurred in 9 patients, 8 were venous leakage, and 1 was pedicle outside, and during the surgery time, two patients had sudden hypotension, no death or incision infection was occurred. Conclusion: Complications of balloon kyphoplasty occur in a higher rate, adopting the corresponding measures can effectively reduce the occurrence, and it will generally not cause clinical adverse consequences. 　　[Key words] Balloon kyphoplasty; Complications; Countermeasures 　　 　　经皮椎体成形术是在1987年由法国的Galibert等首先应用于椎体血管瘤,1990年,Galibert率先将该技术应用于治疗骨质疏松引起的压缩性骨折。经皮椎体后凸成形术(PKP)是在2001年由Garfin等首先报道用于骨质疏松性椎体压缩性骨折的治疗,PKP除了同样具有良好的止痛效果外,而且还可以比PVP更好地恢复椎体高度,改善脊柱生理弯曲[1]。笔者通过分析我院采用Kyphon球囊后凸成形方法治疗的38例骨质疏松性椎体压缩性骨折患者的住院及随访资料,对并发症进行探讨。 　　1 材料与方法 　　1.1 一般资料 　　2005年12月～2008年12月,我科运用Kyphon球囊后凸成形术治疗的骨质疏松性椎体压缩性骨折并获得随访的患者共38例53椎,其中,男14例,女24例,男女之比为1∶2;年龄53～83岁,平均62.8岁。均以腰背部疼痛为主诉,病程1 d～3年,平均1.2年。骨折椎体从T11～L5。术前经X线平片和(或)CT证实椎体后壁完整,椎管内无明显受压。 　　1.2 治疗经过 　　1.2.1 器械与设备骨水泥采用