【摘要】 目的探讨椎体成形术(PVP)联合唑来膦酸治疗老年慢性阻塞性肺疾病(COPD)并胸腰椎骨质疏松压缩性骨折的临床效果。方法选取2012年6月~2014年6月潮州市中心医院收治的老年COPD并胸腰椎骨质疏松压缩性骨折并行PVP术患者24例,术后第3天静脉滴注唑来膦酸。于术前、术后1周、术后1年,比较患者腰背部疼痛视觉模拟评分(VAS)、肺活量(VC)、用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)/FVC的比值(FEV1%)的变化;分析VAS评分及肺功能系数之间的相关性;比较患者术前、术后一年骨密度(BMD)的变化。结果所有患者手术均顺利完成,术后患者疼痛明显减轻或消失。患者均于术后7 d内出院,出院前可站立行走,生活自理。患者术后1周VAS评分明显低于术前(P<0.01),术后1周VC、FVC、FEV1%优于术前(P<0.01或P<0.05)。术后1年VAS评分及VC、FVC、FEV1%亦优于术前(P<0.01),且也优于术后1周的情况(P<0.01或P<0.05)。VAS评分与VC、FVC、FEV1%呈负相关(r=-0.0964、-0.0702、-0.533,P<0.01)。本组患者术后一年腰椎BMD高于术前(P<0.01)。结论 PVP联合唑来膦酸治疗老年COPD并胸腰椎骨质疏松压缩性骨折,能快速解除患者疼痛、恢复活动能力、帮助恢复肺功能,还能增强骨密度、预防再骨折的发生,疗效良好。更多还原

【Abstract】 Objective To study the clinical efficacy of percutaneous vertebroplasty(PVP) associated with zoledronic acid in the treatment of gerontal patient with COPD and osteoporotic thoracolumbar compression fractures. Methods From June 2012 to June 2014, in Central Hospital of Chaozhou, 24 gerontal patients with COPD, osteoporotic thoracolumbar compression fractures and underwent PVP were selected, they were given intravenous Zoledronic acid on the third day. Changes of pain visual analogue scale(VAS) of low back, vital capacity(VC), forced vital capacity(FVC), 1 s forced expiratory volume(FEV1) /FVC ratio(FEV1%) before the surgery, after the surgery 1 week, after the surgery1 year were compared; the correlation between VAS scores and lung coefficient was analyzed; the changes of before and after surgery were compared. Results All the surgery completed successfully, and the postoperative pain of patients reduced significantly or disappeared. All the patients discharged in 7 days after the operation, and they could stand,walk, and take care of themselves before the discharge. the VAS after the surgery 1 week was lower than that before the surgery(P < 0.01), VC, FVC, FEV1% after the surgery 1 week were better than that before the surgery(P < 0.01). The VAS and VC, FVC, FEV1% after the surgery 1 year were better than those before the surgery(P < 0.01), and these were better than those after the surgery 1 week(P < 0.01 or P < 0.05). The VAS had significant negative correlation with VC,FVC, FEV1%(r =-0.0964,-0.0702,-0.533, P < 0.01). BMD of vertebra lumbalis after surgery 1 year was higher than that before the surgery(P < 0.01). Conclusion Applying PVP combined with and Zoledronic acid in treatment of gerontal patient with COPD and osteoporotic thoracolumbar compression fractures can make a benefit of relieving pain,restoring mobility, restoring lung function of the patient,it can increase the bone density and prevent the refracture and achieve good efficacy.更多还原