骨质疏松性椎体压缩性骨折手术治疗后的死亡率分析

背景：骨质疏松性椎体压缩性骨折（OVCFs）是老年人常见的骨折类型,椎体成形术（PVP）或椎体后凸成形术（PKP）可有效缓解OVCFs引起的疼痛,提高老年患者的生活质量,国内外针对其术后死亡率的相关文献报道鲜见。目的：总结OVCFs手术治疗的术后死亡率,探讨患者术后死亡的原因。方法：回顾性分析2003年3月至2010年6月因OVCFs行PVP或PKP并获得随访的203例患者资料。根据总体死亡率和术后1年内死亡率分析患者的死亡原因及其构成特点。结果：PVP或PKP治疗OVCFs的术后死亡率为14.7%%（30/203）,术后1年内死亡率为5.4%（11/203）,无一例发生围手术期死亡。死亡原因依次为心血管事件（9例）、呼吸功能衰竭（7例）、慢性疾病引起的多器官功能衰竭（5例）、恶性肿瘤（5例）、脑血管疾病（3例）、原因不明（1例）。统计结果显示年龄、性别、是否有基础疾病是影响死亡率的主要因素。PVP与PKP治疗OVCFs的患者死亡率无统计学差异。结论：行PVP或PKP治疗OVCFs的创伤小,能显著缓解疼痛,适用于高龄患者,可降低术后死亡率。

Mortality of osteoporotic vertebral compression fractures treated with vertebral body augmentation

Background： Osteoporotic vertebral compression fractures （OVCFs） are the most common fractures in elderly patients. Per- cutaneous vertebroplasty （PVP） or percutaneous kyphoplasty （PKP） has demonstrated dramatic effectiveness of pain relief and improve quality of life. However, there were few reports on postoperative death. Objective： To analyze postoperative mortality of OVCFs and to explore cause of death. Methods： We collected the clinical data of 203 aged OVCFs patients who had been treated with PVP or PKP from March 2003 to June 2010. The overall mortality and one-year mortality after surgery were analyzed to find the causes for death. Results： The overall mortality and one-year mortality was 14.7% （30/203） and 5.4%（11/203）, respectively. No one died in perioperative period. Cardiac event （9 cases）, pulmonary nonfimction （7 cases）, multiple organ failure （5 cases）, malignant tumor （5 cases）, cerebral vascular disease （3 cases） were the major causes for death. Statistical results showed that age, sex and underlying diseases were definitely related to mortality. But there was no significant difference in the mortality between PVP and PKP for OVCFs. Conclusions： Both PVP and PKP can significantly relieve pain and reduce postoperative mortality for elderly patients with OVCFs.