骨质疏松性脊柱骨折患者腰背部抽搐样疼痛的治疗

摘要

目的 为骨质疏松性脊柱骨折患者寻找一种快速缓解腰背部抽搐样疼痛的治疗方法.方法 回顾分析2006年8月～2010年2月我科收治的出现腰背部抽搐样疼痛的骨质疏松性脊柱骨折患者110例,按照治疗方法将病人分为3组:A组31例,行抗骨质疏松的基础治疗与止痛治疗,包括口服乐力钙胶囊、阿法骨化醇片、仙灵骨葆胶囊与曲马多胶囊,肌注鲑鱼降钙素;B组47例,在A组的基础上,将口服钙换成静脉推注葡萄糖酸钙或氯化钙,配合局部小针刀治疗;C组32例,采用经皮椎体成型术与B组的治疗措施(其中9例未采用小针刀治疗).比较3组在治疗1、3、5、7天后腰背部疼痛的缓解情况与卧床翻身功能,并比较3组患者抽搐样腰背部疼痛完全缓解所需要的时间.结果 治疗前,3组的腰背部疼痛评分与卧床翻身功能评分之间无统计学意义(P＞0.05);治疗后,3组患者腰背部部疼痛评分与卧床翻身功能评分均呈现逐渐下降的趋势,B组较A组下降较快且较明显,C组最快最明显.3组患者抽搐样腰背部疼痛缓解所需要时间,C组短于B组(P＜0.01),B组短于A组(P＜0.01).结论 全身与局部相结合的综合治疗可以提高骨质疏松脊柱骨折患者腰背部抽搐样疼痛的疗效,是缓解骨质疏松性脊柱骨折患者抽搐样腰背部疼痛的有效方法.%Objective To explore a quick and effective method for the treatment of lumbar or back convulsive pain of the patients with osteoporotic vertebral fractures . Methods Totally 110 osteoporotic vertebral fractures patients with lumbar or back convulsive pain from Aug . 2006 to Feb. 2010 were analyzed retrospectively. There were 102 females and 8 males with the average age of (72. 9 ± 10. 2) years. According to the treatment method ,the patients were divided into group A ,B and C. Patients in group A were treated with Osteoform calcium capsule ,Afacalcidol tablet ,Xianlingubao capsule ,tramadol capsule ,Calcitonin. Patients in group B were performed the same treatment with group A ,in addition ,they were taken Calcium by injection instead of oral taking ,and they were performed small needle-knife comprehensive therapy. Patients in group C were performed percutaneous vertebroplasty and the same treatment measures in group B, but 9 cases were not performed small needle-knife comprehensive therapy. Patients' pain remittance 1,3,5, 7 days following operation and capability scores of turning over in bed ,were compared among the three groups. Meanwhile, the time for convulsive pain healing of lumbar or back was observed . Results Before treatment, there was no significant difference in the degrees of lumbar or back pain and capability scores of turning over in bed in three groups (P >0.05). During 7 days after treatment, the degrees of lumbar or back pain and capability scores of turning over in bed in three groups decreased gradually . To the decreased degree of lumbar or back pain and capability scores of turning over in bed , patients in group C decreased more remarkably than group B, while group B more remarkably than group A. The time needing for healing lumbar or back convulsive pain in group C was less than that in group B (P<0.01) ,so was that group B to group A(P<0.01). Conclusion Combined therapy ( systemic and local) is an effective method to relieve lumbar or back convulsive pain for the patients with osteoporotic vertebral fractures .