PVP和PKP治疗骨质疏松性椎体压缩骨折的疗效观察和护理

目的观察及对比经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折的疗效和护理。方法在68例骨质疏松性椎体压缩骨折患者中,38例59个椎体接受PVP治疗;30例40个椎体接受PKP治疗。术前及术后1d进行疼痛视觉类比评分(visual analog scale,VAS)和伤椎体高度恢复情况比较。结果 PVP组术前和术后1dVAS评分别为(7.1±1.2)分和(2.0±0.6)分,PKP组分别为(6.9±1.0)分和(1.9±0.8)分,差异有统计学意义(P﹤0.05)。术后6～24个月(平均18个月)随访,PVP组和PKP组伤椎高度分别较术前增加(2.3±1.6)mm和(9.1±2.0)mm,两组比较差异有统计学意义(P﹤0.05)。结论 PVP和PKP治疗骨质疏松性椎体压缩骨折对止痛均有明显效果,二者无明显差异;PKP伤椎高度恢复明显优于PVP;同时给予安全、有效的护理对PVP、PKP患者的恢复至关重要。

Nursing and Observation on the treatment of Osteoporotic Vertebral Compression Fracture with PVP and PKP

OBJECTIVE To compare the effectiveness and nursing of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in treatment of osteoporotic vertebral compression fracture. METHODS In the 68 cases of osteoporotic vertebral compression fracture,38 cases were treated with PVP(on 59 vertebrae)and 30 cases were treated with PKP(on 40 vertebrae). Visual analog scale(VAS)and increased height of injured vertebrae after surgery were used for evaluation. RESULTS The VAS were observed(P﹤0.05)before and after surgery between PVP and PKP groups,the VAS decreased from 7.1±1.2 to 2.0±0.6 and from 6.9±1.0 to 1.9±0.8 in PVP and PKP group,respectively. Patients in two groups were closely monitored after surgery for 6 to 24 months,with the average of 18 months. PVP and PKP increased the height of injured vertebrae by 2.3±1.6 mm and 9.1±2.0 mm,respectively,and they showed significantly different. CONCLUSION Both PVP and PKP could significantly alleviate pain of osteoporotic vertebral compression fracture,with similar effectiveness;However,PKP increased more in height of injured vertebrae than PVP. Psychological and effective nursing plays a key role in recovering from PVP or PVP surgery.