经皮椎体成形术与保守治疗骨质疏松性椎体压缩性骨折的疗效和安全性比较

目的探讨经皮椎体成形术与保守治疗骨质疏松性椎体压缩性骨折（OVCF）的临床疗效及安全性。方法选取OVCF患者101例，按随机数字表法分为两组，手术治疗组42例，行经皮椎体成形术治疗；保守治疗组59例，采用卧休、药物等保守治疗；观察比较两组临床疗效以及安全性。结果手术治疗组术后椎体前缘高度恢复至（37．6±6．7）mm，后凸Cobb角矫正至（5．6±3.9）°与保守治疗组的（23．6±5．6）mm及（6．3±4．1）差异均有统计学意义（t=4．09、3．87，均P〈0．05）。治疗3个月后，手术治疗组视觉模拟评分（VAS）（0．42±0．12）分，显著低于保守治疗组的（1．23±0．23）分（t=3．65、P〈0．05）；手术治疗组术后3个月，Oswest功能障碍指数问卷表（ODI）为（4．42±1．12）分，低于保守治疗组的（11．23±2．23）分（t=8．96、P〈0．05）。保守治疗组出现压疮、肺部感染及泌尿系统感染共5例（5／59，8．47％），而手术治疗组则无（0／42，0．00％）（X^2=5．09、P〈0．05）。结论与保守治疗OVCF相比，经皮椎体成形术是一种简单、微创、安全有效的治疗方法。

Comparison of the effect and safety of percutaneous vertebroplasty and conservative therapy in the treatment of osteoporotic vertebral compressive fractures

Objective To investigate the effect and safety of percutaneous vertebroplasty（PVP） and conservative therapy in the treatment of osteoporotic vertebral compression fractures（OVCF）. Methods 101 patients with OVCF were randomly divided into two groups. 42 cases in the operation group received PVP treatment ,59 cases in the control group received conservative treatment. The therapeutic effect and safety were observed and compared. Results In the surgical treatment group, the vertebroplasty vertebral height was restored to （ 37.6 ＋ 6.7 ） ram, the kyphosis Cobb angle was corrected to （5.6 ± 3.9 ） °. Those in the conservative treatment group were （ 23.6 ± 5.6 ） mm, （ 6.3 ± 4. 1 ） °, and the differences between the two groups were statistically significant （ t = 4.09,3.87, all P 〈 0.05 ）. After 3 months Of treatment, VAS score of the operation group was （ 0.42 ± 0. 12 ） points, which was signifi- cantly lower than （ 1.23 ± 0.23 ） points in the conservative treatment group （ t = 3.6.5, P 〈 0.05 ）. Postoperative 3 months,ODI score of the operation group was （4.42 ±1.12） points,which was significantly lower than （ 11.23 ± 2. 23） points of the conservative treatment group （ t = 8.96, P 〈 0.05）. Conclusion PVP is a simple, minimally in- vasive, safe and effective method in the treatment of OVCF.