【摘要】 【目的】比较采用两种填充物聚甲基丙烯酸酯(polymethylmethacrylate,PMMA)和锶羟磷灰石(strontium-contained hydroxyapatitecement,SrHAC)行经皮椎体成形术(percutaneous vertebroplasty,PVP)的临床应用结果。【方法】选择单椎体骨折患者49例,其中男19例,女30例,随机分成2组,PMMA组26例,SrHAC组23例,对填充物注入量、术中患者血压、心率、血氧饱和度及术后填充物渗漏、疼痛改善、临床效果、影像学征象等指标进行评价分析。【结果】PMMA组平均注入量为(2.82±0.39)mL,SrHAC组平均注入量为(3.75±0.52)mL,两组比较差异有统计学意义(P<0.01)。SrHAC组注入填充物时血压、心率、血氧饱和度稳定。PMMA组视觉模拟量表(visual analogue pain scale,VAS)评分由术前平均的(7.0±0.8)分下降至末次随访时的(1.7±0.4)分;SrHAC组术前平均为(7.2±1.0)分,末次随访降为(1.8±0.5)分。两组组内比较手术前后差异均有统计学意义(P<0.01)。术后临床效果SC法评价,优良率:PMMA组为84.6%、SrHAC组为82.6%,两组比较差异无统计学意义(P>0.05)。末次随访时椎体均无继续塌陷征象。随访达1年以上的SrHAC组见填充物开始降解。【结论】应用两种填充剂行PVP均为治疗骨质疏松性椎体压缩性骨折的有效办法。更多还原

【Abstract】 [Objective] To compare the clinic effects of percutaneous vertebroplasty by using polymethyl-methacrylate (PMMA) and strontium-contained hydroxyapatite cement(SrHAC). [Methods] Forty-nine cases ( male 19, female 30 ) of osteoporotic vertebral compressive fracture were divided into 2 groups: PMMA (26 cases), SrHAC (23 cases). The injective cement volume, the patient′s blood pressure, heart rate, and saturation of blood oxygen were recorded. The patient with visual analogue pain scale(VAS) were evaluated. The radiography preoperatively and postoperatively were observed. [Results] Average (2.82±0.39)mL PMMA and (3.75±0.52)mL SrHAC were injected in each group respectively. The difference between these two group was significant(P< 0.01), the patient’s blood pressure, heart rate, and saturation of blood oxygen were stable during the cement injection in both groups. The VAS was 7.0±0.8 preoperatively and 1.7±0.4 postoperatively in PMMA group. At the same time, the VAS was 7.2±1.0 preoperatively and 1.8±0.5 postoperatively in SrHAC group. Stauffer-Coventry(SC) measuring: excellent and good results in PMMA groups and SrHAC group were 84.6% and 82.6% respectively. There was no case with collapse continuing in last follow-up. [Conclusion] As using PMMA, PVP used with the strontium-containing hadroxyapatite cement is an effective and safety therapy in the spinal diseases.更多还原