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应用可弯曲骨水泥注入器单侧穿刺行经皮椎体成形术的可行性及疗效

Feasibility and curative effect of percutaneous vertebroplasty with flexible bone cement injector

摘要:

目的 探讨应用可弯曲骨水泥注入器单侧穿刺行经皮椎体成形术(PVP)的可行性及疗效.方法 回顾性分析78例经单侧穿刺行PVP治疗的胸、腰椎压缩骨折患者的临床资料,根据使用器材的不同分为观察组和对照组.观察组36例,应用可弯曲骨水泥注入器,3点注入骨水泥;对照组42例,应用普通直型骨水泥注入器.记录两组患者的手术时间、放射暴露时间、骨水泥注入量,观察骨水泥渗漏情况.术后1周、1年、2年进行随访,记录疼痛视觉模拟评分(VAS)、病变椎体相对高度和Cobb角的情况.采用独立样本t检验(正态分布的计量资料)或χ2检验(计数资料)比较两组患者间手术时间、放射暴露时间、骨水泥注入量、骨水泥渗漏发生率、VAS、椎体相对高度、Cobb角等的差异.结果 两组均顺利完成手术.观察组和对照组的手术时间、放射暴露时间、骨水泥渗漏发生率差异均无统计学意义(P>0.05);观察组和对照组骨水泥注入量分别为(5.6±0.7)、(3.2±0.6)ml,差异有统计学意义(P<0.05).两组间术后1周的VAS评分、病变椎体相对高度及Cobb角差异均无统计学意义(P>0.05),而术后1年及2年两组患者的上述指标差异均有统计学意义(P<0.05),观察组优于对照组.结论 应用可弯曲骨水泥注入器行PVP安全可行.与传统的直型骨水泥注入器相比,应用可弯曲骨水泥注入器在不增加手术时间、放射暴露时间和骨水泥渗漏发生率的前提下,远期疗效更优.

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abstracts:

Objective To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) with flexible bone cement injector through unilateral puncture. Method Unilateral puncture line PVP treatment for thoracolumbar vertebral compression fracture was conducted in 78 patients, which was divided into observation group and control group according to the use of different equipment. The flexible bone cement injector was used in 36 cases of observation group, which injected the bone cement into three places at the vertebral body. The ordinary straight bone cement injector was applied in the 42 cases of the control group. The operation time, the time of radiation exposure, and the amount of bone cement injection were recorded, and the leakage of bone cement was observed. The visual analogue scale (VAS), relative vertebral height and Cobb angle were recorded at 1 week, 1 and 2 years follow-up. The time of operation, the time of radiation exposure, the amount of bone cement injection, the incidence of bone cement leakage, VAS, relative height of vertebral body and Cobb angle were compared between the two groups using independent samples t test orχ2 test. Result All patients in the two groups were successfully treated by surgery. There were no significant differences between the observation group and the control group in the operation time and the time of radiation exposure and the incidence of bone cement leakage (P>0.05). The injection amounts of bone cement in the observation group and the control group were (5.6 ± 0.7) and (3.2 ± 0.6) ml, with statistically significant difference (P<0.05). There were no significant differences in VAS score, relative vertebral height and Cobb angle between the two groups at 1 week after operation (P>0.05). At 1 year and 2 years after operation, the differences of the above indexes between the two groups were significantly different (P<0.05), with the observation group being superior to the control group. Conclusions Application of flexible bone cement injector for PVP operation is safe and feasible. Compared with the traditional straight bone cement injector, the use of flexible bone cement injector will not increase the operation time, radiation exposure time and the incidence of bone cement leakage but will improve the long-term effect.

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作者: 李玉伟 [1] 崔红领 [1] 王海蛟 [1]
期刊: 《中华放射学杂志》2017年51卷4期 293-298页 MEDLINEISTICPKUCSCD
栏目名称: 介入放射学
DOI: 10.3760/cma.j.issn.1005-1201.2017.04.012
发布时间: 2020-05-07
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