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目的探讨骨质疏松性椎体压缩性骨折患者单侧经皮穿刺椎体成形术术中不同穿刺方法的特点及其临床疗效。方法选取本院收治的50例骨质疏松性单个椎体压缩性骨折高龄女性患者,随机分成AB两组,其中PVP术中A组患者采用偏侧穿刺(正位X线照片穿刺针尖约位于穿刺侧椎弓根眼内侧皮质与棘突中线中心),B组采用中心穿刺(穿刺针尖位于棘突中线),所有患者术前视觉模拟疼痛评分(VAS)、术中手术时间、穿刺方法对比、及术后及随访疗效VAS评分。结果平均手术时间A组:26±5min,B组:38±7min,统计学分析有差异性(P<0.05);骨水泥渗漏率A组8%,B组:16%,统计学分析有差异性(P<0.05);术前、术后24h、术后6月AB两组VAS评分及随访结束VAS评分改善值统计学分析没有明显差异性(P>0.05)。结论简化单侧经皮穿刺椎体成形术术中穿刺定位方法能减少手术时间,避免更多X线照射,手术操作简单,更安全、疗效肯定,更适合基层医院开展运用。
Objective To investigate the characteristics and clinical effects of different methods of percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. Methods A total of 50 elderly osteoporotic women with osteoporotic vertebral compression fractures were selected and divided into two groups at random. The patients in group A underwent PVP (group A) Lateral center of lateral peduncular cortex and spinous process center). In group B, central puncture (median puncture needle was located in the midpoint of spinous process), visual analogue pain score (VAS), intraoperative operation time, puncture method and Postoperative and follow-up efficacy VAS score. Results The mean operation time was 26 ± 5 minutes in group A and 38 ± 7 minutes in group B, with statistical difference (P <0.05). The rate of bone cement leakage was 8% in group A and 16% in group B, respectively (P <0.05). There was no significant difference between the two groups in VAS score before operation, 24h after operation, 6th month after operation, and VAS score at follow-up (P> 0.05). Conclusions Simplification of percutaneous vertebroplasty with unilateral percutaneous puncture can reduce the operation time and avoid more X-ray irradiation. The operation is simple, safe and effective, and is more suitable for the primary hospital.