预防骨水泥渗漏微创手术治疗老年椎体骨折的疗效比较
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江西省抚州市东乡区中医院

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To compare the efficacy of minimally invasive surgery in the treatment of elderly vertebral fractures by preventing bone cement leakage
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Dongxiang District Hospital of Traditional Chinese Medicine, Fuzhou City, Jiangxi Province

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    摘要:

    [目的]比较三种微创手术方法治疗老年椎体骨折的疗效并分析。[方法]回顾性分析本院自2020年1月-2022年12月收治的80例老年椎体骨折患者,均采用微创手术方法进行治疗,按手术方式分为PKP组20例,分期骨水泥注射组30例,明胶海绵组30例。记录围手术期情况,观察比较手术前后VAS评分,后凸角矫正度,手术时间,骨水泥注入量,术后住院天数,手术费用等。正态分布的计量资料采用方差分析,数据用(±s)表示,组内 VAS 比较采用配对样本t检验。计数资料比较采 用X2 检验(或Fisher精确检验)。[结果]三组手术在手术前后VAS评分、骨水泥注入量、术后住院天数均无统计学意义P>0.05;PKP组在后凸角矫正度上明显具有优势,三组数据对比P<0.05,有统计学意义;手术时间:明胶海绵组用时最短,较其他两组比较P<0.05,有统计学意义;手术费用:PKP组花费最多,另两组花费接近。[结论]预防骨水泥渗漏的微创手术中,三组手术方案各有优势,PKP手术适用于需要恢复后凸畸形的患者,但花费较高;骨水泥分期注射组在三组微创手术中在各个数据中较均衡,是一种很好的手术方式,但因分期注射具有一定难度,需要手术医生进行系统学习;明胶海绵组手术方式简单,手术时间短,但具有一定的渗漏风险。

    Abstract:

    Abstract: [Objective] To compare and analyze the efficacy of three minimally invasive surgical methods in the treatment of vertebral fractures in the elderly. [Methods] Eighty elderly patients with vertebral fractures admitted to our hospital from January 2020 to December 2022 were retrospectively analyzed. All patients were treated with minimally invasive surgery. According to the surgical method, they were divided into PKP group (20 cases), staged bone cement injection group (30 cases), and gelatin sponge group (30 cases). The preoperative and postoperative VAS score, kyphosis correction, operation time, bone cement injection volume, postoperative hospital stay, and operation cost were observed and compared. The measurement data with normal distribution were analyzed by analysis of variance, and the data were expressed as (±s). The paired sample t test was used to compare the VAS within the group. The chi-square test (or Fisher''s exact test) was used to compare the count data.[Results] There was no significant difference in VAS score before and after operation, bone cement injection volume and postoperative hospital stay among the three groups (P>0.05). The PKP group had obvious advantages in the correction of kyphosis Angle, and the comparison of the three groups of data was P<0.05, which was statistically significant. The operation time of gelatin sponge group was shorter than the other two groups (P<0.05). The cost of PKP group was the highest, and the cost of the other two groups was close. [Conclusion] In the prevention of bone cement leakage, the three surgical methods have their own advantages. PKP is suitable for the patients who need to restore kyphosis, but the cost is high. In the three groups of minimally invasive surgery, the staged injection group of bone cement is more balanced in each data, which is a good surgical method, but because of the difficulty of staged injection, the surgeon needs to learn systematically. The operation method of gelatin sponge group is simpler and the operation time is shorter, but there is a certain risk of leakage.

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  • 收稿日期:2023-03-08
  • 最后修改日期:2023-03-08
  • 录用日期:2023-05-06
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