| 贾小宝,吴 宇,冷楠楠,刘国印,陈建民.PKP术中不同骨水泥填充剂量治疗骨质疏松性椎体压缩性骨折的疗效对比及术后骨水泥渗漏的影响因素探讨[J].,2023,(4):698-703 |
| PKP术中不同骨水泥填充剂量治疗骨质疏松性椎体压缩性骨折的疗效对比及术后骨水泥渗漏的影响因素探讨 |
| Comparison of the Efficacy of Different Doses of Bone Cement in the Treatment of Osteoporotic Vertebral Compression Fractures during PKP Operation and Discussion of the Influencing Factors of Postoperative Bone Cement Leakage |
| 投稿时间：2022-07-28 修订日期：2022-08-23 |
| DOI：10.13241/j.cnki.pmb.2023.04.019 |
| 中文关键词: 骨水泥 剂量 骨质疏松性椎体压缩性骨折 经皮椎体后凸成形术 骨水泥渗漏 影响因素 |
| 英文关键词: Bone cement Doses Osteoporotic vertebral compression fracture Percutaneous kyphoplasty Bone cement leakage Influencing factors |
| 基金项目:江苏省自然科学基金面上项目（BK20181113） |
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| 中文摘要: |
| 摘要 目的：对比经皮椎体后凸成形术（PKP）中不同骨水泥填充剂量治疗骨质疏松性椎体压缩性骨折（OVCF）的疗效，采用单因素和多因素Logistic回归因素分析骨水泥渗漏的影响因素。方法：回顾性分析我院2019年7月-2021年3月期间在骨科住院行PKP术治疗的120例OVCF患者的临床资料。根据不同骨水泥填充剂量将患者分为低剂量组（2~3 mL骨水泥，n=39）、中剂量组（3~6 mL骨水泥，n=41）和高剂量组（6~7 mL骨水泥，n=40）。对比三种剂量下的骨水泥填充后的手术效果。收集所有患者的一般资料并记录骨水泥渗漏情况，根据患者术后是否发生骨水泥渗漏分成渗漏组（n=25）和无渗漏组（n=95），采用单因素和多因素Logistic回归因素分析骨水泥渗漏的影响因素。结果：三组术后1年视觉疼痛模拟评分（VAS）、Oswerstry功能障碍指数（ODI）评分较术前下降（P<0.05）。三组术后1年椎体前缘高度较术前升高，后凸Cobb角较术前下降（P<0.05）。高剂量组、中剂量组的骨水泥渗漏率高于低剂量组（P<0.05）。骨水泥渗漏与术前椎体前缘高度、椎体周壁破坏情况、骨水泥注入量、椎体压缩程度、椎基静脉孔相通、骨密度、骨水泥注射时机、裂隙征有关（P<0.05）。多因素Logistic回归分析结果显示椎体压缩程度≥50%、有椎体周壁破坏情况、骨水泥注射时机为粥状期、骨水泥注入量偏多是骨水泥渗漏的危险因素（P<0.05）。结论：不同骨水泥填充剂量PKP治疗OVCF均有效，但低剂量组的骨水泥渗漏率更低。同时，骨水泥渗漏发生的危险因素还包括骨水泥注入量、椎体周壁破坏情况、椎体压缩程度、骨水泥注射时机等。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of different dosage of bone cement in the treatment of osteoporotic vertebral compression fracture (OVCF) in percutaneous kyphoplasty (PKP). Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of bone cement leakage. Methods: The clinical data of 120 patients with OVCF who underwent PKP in the Department of Orthopedics in our hospital from July 2019 to March 2021 were retrospectively analyzed. Patients were divided into low-dose group (2~3 mL cement, n=39), medium-dose group (3~6 mL cement, n=41) and high-dose group (6~7 mL cement, n=40) according to different cement filling doses. The surgical effect of bone cement filling at three different doses were compared. The general data of all patients were collected and the bone cement leakage was recorded, all patients were divided into leakage group (n=25) and non-leakage group (n=95) according to the occurrence of postoperative bone cement leakage. Univariate and multivariate Logistic regression were used to analyze the influencing factors of bone cement leakage. Results: The visual pain analogue scale (VAS) and Oswerstry Disability index (ODI) scores of the three groups at 1 year after operation were lower than those before operation (P<0.05). 1 year after operation, the vertebral anterior edge height of the three groups was higher than that before operation, and the kyphotic Cobb angle was lower than that before operation (P<0.05). The bone cement leakage rate of the high-dose group and medium-dose group was higher than that of the low-dose group (P<0.05). Bone cement leakage was related to the preoperative height of anterior vertebral body, the damage of perivertebral wall, the amount of bone cement injection, the degree of vertebral compression, the intercommunication of vertebral base venous foramen, bone mineral density, the timing of bone cement injection, and fracture sign (P<0.05). The results of multivariate Logistic regression analysis showed that degree of vertebral compression≥50%, damage of perivertebral wall, timing of bone cement injection in congee stage, and excessive amount of bone cement injection were risk factors for bone cement leakage (P<0.05). Conclusion: Different doses of PKP are effective in the treatment of OVCF, but the bone cement leakage rate is lower of the low-dose group. At the same time, the risk factors of bone cement leakage also include the amount of bone cement injection, the damage of perivertebral wall, the degree of vertebral compression, and the timing of bone cement injection. |
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