【摘要】 目的:探讨骨水泥体积分数对术中骨水泥的注射量的指导意义。方法:回顾性分析85例骨质疏松性椎体压缩性骨折患者的临床资料。所有的患者均为新鲜单节段胸腰椎压缩性骨折,采用单侧经皮椎体成形术手术治疗。记录患者术前、术后的疼痛视觉模拟评分(VAS),术中骨水泥注入量和骨水泥弥散情况。利用Mimics软件计算责任节段的椎体体积,计算骨水泥的注入量和椎体体积的比值,根据该比值的大小将患者分为三组,小剂量组(≤0.1,11例),中剂量组(0.1~0.2,48例)和大剂量组(≥0.2,26例)。结果:85例患者均顺利完成手术治疗,患者的骨水泥体积分数在0.08~0.27之间,平均0.14±0.07。术前VAS评分:小剂量组为(7.82±0.88)分,中剂量组为(7.65±1.02)分,大剂量组为(7.35±1.13)分;术后VAS改善评分:小剂量组为(5.36±0.81)分,中剂量组为(5.75±0.94)分,大剂量组为(5.42±1.14)分。三组患者的术前、术后VAS评分比较,差异均有统计学意义(P<0.05)。但术前和术后三组之间的VAS评分两两比较,差异均无统计学意义(P>0.05)。有12例患者发生骨水泥渗漏,其中10例患者发生在大剂量组,所有的患者均无骨水泥渗漏的相关临床症状出现。结论:术中使用中小剂量的骨水泥(小于20%的骨水泥体积分数)即可达到有效的治疗效果;追求更多的骨水泥注入量(骨水泥体积分数≥20%)并不能增加疗效,反而可能会增加骨水泥渗漏的风险。更多还原

【Abstract】 Objective The objective of this study was observe the significance of bone cement volume fraction(BCVF) for intraoperative injection volume of bone cement. Method Retrospective analysis the clinical date of 85 patients with OVCF. All of them were single vertebrae fresh fracture and treated with unilateral percutaneous vertebroplasty. Visual Analogue Scale score(VAS) was observed before and after the operation,the injection volume and dispersion of the bone cement also were recorded.The volume of vertebrae was measured with Mimics software. According to the BCVF,the patients were divided into 3 groups: low-dosage group(≤0. 1,11 patients); mid-dosage group(0. 1 ~ 0. 2,48 patients); high-dosage group(≥0. 2,26 patients). Results All patients were treated with the PVP successfully. The BCVF ranged from 0. 08 to 0. 27(0. 14 ± 0. 07). Preoperative VAS score was(7. 82 ± 0. 88) in the low-dosage group,(7. 65 ± 1. 02) in the mid-dosage group and(7. 35 ± 1. 13) in the high-dosage group. The improve postoperative VAS score was(5. 36 ± 0. 81) in the low-dosage group,(5. 75 ± 0. 94) in the mid-dosage group and(5. 42 ± 1. 14) in the high-dosage group. The differences of preoperative and postoperative VAS scores were significant in all groups(P < 0. 05); whereas,there were no significant differences in the VAS scores among the threes groups before and after the operation(P > 0. 05). Bone cement leakage occurred in 12 patients. Ten patients were from high-dosage group,all of them was no clinical symptoms. Conclusion A mid or small dose of bone cement(BCVF < 20%) can achieve satisfied therapeutic effect. Higher injection dose of bone cement(BCVF≥20%) does not increase the clinical effect,but may increase the risk of bone cement leakage.更多还原