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目的:观察PKP与PVP治疗骨质疏松性椎体骨折疗效和安全性。方法:随机选择2014年1月-2016年7月至台州市立医院进行PVP和PKP治疗的骨质疏松性椎体骨折(OVCFs)患者各350例,分为为PVP组和PKP组作为研究对象。PVP组患者行经皮椎体成形术。PKP组患者行经皮椎体后凸成形术。比较两组患者手术情况、两组患者手术前后疼痛程度、手术前后椎体前缘、椎体后缘以及椎体后凸角以及两组患者骨水泥渗透率。结果:PKP组患者手术时间长于PVP组,且具有统计学差异(P<0.05),两组患者术中失血量无明显差异,均未发生严重并发症。两组患者术前1d、术后1d、术后4周和术后24周的VAS评分均无明显差异。两组患者治疗前、后椎体前缘、椎体后缘以及椎体后凸角无明显组间差异(P>0.05)。PVP组患者发生骨水泥渗透率为28.28%,明显高于PKP组的13.42%,且具有统计学差异(P<0.05)。结论:PKP与PVP在治疗骨质疏松性椎体骨折中疗效上无明显差异,但是PKP能够降低术后骨水泥渗透的发生率,其安全性更好。
Objective: To observe the efficacy and safety of PKP and PVP in the treatment of osteoporotic vertebral fractures. Methods: A total of 350 patients with osteoporotic vertebral fractures (OVCFs) who underwent PVP and PKP from January 2014 to July 2016 in Taizhou City Hospital were randomly divided into PVP group and PKP group. PVP patients underwent percutaneous vertebroplasty. Patients in the PKP group underwent percutaneous kyphoplasty. The operation conditions were compared between the two groups. The degree of pain before and after operation, the anterior and posterior edge of vertebral body, posterior edge of vertebral body and kyphosis angle of the two groups were compared. The bone cement permeability of the two groups was also compared. Results: The operation time of PKP group was longer than that of PVP group (P <0.05). There was no significant difference between the two groups in the amount of blood loss and no serious complications occurred. There was no significant difference in VAS score between the two groups at 1 day before operation, 1 day after operation, 4 weeks after operation and 24 weeks after operation. There were no significant differences between the two groups before and after treatment in the anterior, posterior, and kyphosis (P> 0.05). The bone cement permeability in PVP group was 28.28%, which was significantly higher than that in PKP group (13.42%, P <0.05). Conclusion: There is no significant difference between PKP and PVP in the treatment of osteoporotic vertebral fractures. However, PKP can reduce the incidence of postoperative bone cement infiltration, and its safety is better.