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目的观察分析经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗骨质疏松性腰椎压缩骨折的临床效果。方法 80例骨质疏松性腰椎压缩骨折患者,随机分为甲组与乙组,各40例。甲组采用PKP治疗,乙组采用PVP治疗。比较两组的临床治疗效果。结果乙组手术时间(37.09±11.20)min、住院时间(7.81±3.12)d、医疗费用(0.74±0.26)万元均优于甲组(83.67±23.45)min、(10.67±4.58)d、(3.98±1.45)万元(P<0.05);治疗后甲组与乙组视觉模拟评分法(VAS)评分[(2.03±0.44)、(2.07±0.46)分]、Oswestry功能障碍指数(ODI)评分[(20.03±0.56)、(20.01±0.54)分]及Cobb角[(14.09±2.15)、(14.10±2.16)°]较治疗前VAS评分[(7.93±1.82)、(7.90±1.81)分]、ODI评分[(45.13±1.34)、(45.10±1.35)分]、Cobb角[(23.70±5.98)、(23.71±5.97)°]明显降低(P<0.05),椎体前缘高度[(0.86±0.09)、(0.71±0.15)cm]较治疗前[(0.61±0.12)、(0.60±0.11)cm]显著提高(P<0.05),且甲组患者椎体前缘高度高于乙组(P<0.05)。结论在骨质疏松性腰椎压缩骨折治疗中,PKP与PVP均能迅速缓解临床症状,减轻患者身心痛苦,PKP可明显恢复病椎高度,纠正后凸畸形,但其价格昂贵;PVP操作简单、疗效确切、经济性高,两者各有优势,临床应结合患者实际情况,选择最适宜的手术方案,进而实现最佳的治疗效果。
Objective To observe the clinical effect of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) on osteoporotic lumbar compression fractures. Methods 80 cases of osteoporotic lumbar compression fractures were randomly divided into group A and group B, 40 cases each. Group A treated with PKP, Group B treated with PVP. The clinical effects of the two groups were compared. Results The operation time (37.09 ± 11.20) min, hospital stay (7.81 ± 3.12) d, and medical expenses (0.74 ± 0.26) million in group B were significantly better than those in group A (83.67 ± 23.45) min and (10.67 ± 4.58) d respectively (2.03 ± 0.44) and (2.07 ± 0.46) scores, respectively. The scores of Oswestry Disability Index (ODI), VAS score of group A and group B after treatment were significantly lower than that of group B (3.98 ± 1.45) (20.03 ± 0.56), (20.01 ± 0.54) and Cobb angle [(14.09 ± 2.15) and (14.10 ± 2.16) °, respectively) were significantly higher than VAS scores before treatment (7.93 ± 1.82 and 7.90 ± 1.81, respectively) , ODI score (45.13 ± 1.34), (45.10 ± 1.35) points, Cobb angle [(23.70 ± 5.98), (23.71 ± 5.97) °], and anterior vertebral height [(0.86 (0.71 ± 0.15) cm] were significantly higher than those before treatment [(0.61 ± 0.12), (0.60 ± 0.11) cm] (P <0.05), and the height of vertebral body in group A was higher than that in group B P <0.05). Conclusions In the treatment of osteoporotic lumbar compression fractures, both PKP and PVP can quickly relieve the clinical symptoms and relieve their physical and mental pain. PKP can obviously restore the vertebral height and correct the kyphosis, but it is expensive; PVP is simple and effective Exactly, high economy, both have their own advantages, clinical should be combined with the actual situation of patients, choose the most appropriate surgical options, and thus achieve the best therapeutic effect.