骨质疏松性椎体压缩骨折患者的生存质量研究

目的观察中西医结合非手术治疗与椎体成形术和椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者的中长期生存质量。方法采取回顾性研究的方法,收集2006年1月~2008年12月在广东省中医院住院治疗的骨质疏松性椎体压缩骨折患者108例,其中非手术治疗者55例,椎体成形术治疗者53例。以生活质量问卷SF-36量表及视觉直观模拟量表(Visual Analogue Scale,VAS)为测评量表,对比非手术治疗和椎体成形术、椎体后凸成形术治疗超过3年后的生活质量,并观察再骨折的发生率。结果治疗后到随访时间平均50.59个月(36~69个月),SF-36量表评分的生理机能、生理职能、情感职能上非手术组为优于手术组,两组间比较有统计学意义(P值均0.05),其余各维度无统计学意义。VAS评分上非手术组为优于手术组,两组间对比有统计学意义,(P值0.05)。结论就中长期生存质量及疼痛改善程度来看,非手术治疗组优于手术组,且再骨折发生率较低,提示临床工作中要严格把握骨质疏松性椎体压缩骨折患者手术指征。

Research of the quality of life of patients with osteoporotic vertebral compression fractures

Objective To observe medium and long-term quality of life of non-surgical treatment and vertebral plasty in patients with osteoporotic vertebral compression fractures. Methods A retrospective study was performed. A total of 108 patients with osteoporotic vertebral compression fractures, who were hospitalized in Guangdong Provincial Hospital of TCM from January 2006 to December 2006, were selected, including 55 patients with non-operative treatment and 53 patients received vertebral plasty. A SF-36 scale and VAS scale were used, in order to compare the quality of life after non-operative treatment or vertebral plasty for more than 3 years after the treatment. The incidence of re-fractures was observed. Results The average follow-up was 50.59 months (36-69 months). According to the SF-36 scale, the physiological function, physical functioning, and role-emotional were better in non-surgical group than those in vertebral plasty group (P<0.05). In other dimensions, no significant difference was observed. The VAS score in non-surgical group was also better than that in vertebral plasty group (P<0.05). Conclusion Considering the medium and long-term quality of life and pain relief, the efficacy in non-surgical treatment group is superior to that in the vertebral plasty group, and the incidence of re-fractures is much lower, which indicates that strictly observing the surgical indication is important in clinical work.