目的 探讨经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折(OVCF)所致疼痛的临床疗效及止痛机制.方法 2008年1月至2011年3月,采用PVP治疗骨质疏松所致胸腰椎压缩性骨折患者91例(男29例,女62例,年龄56～97岁).根据疼痛视觉模拟评分(VAS)和止痛药服用时间评估患者术前与术后疼痛缓解情况.结果 所有患者均获随访,随访时间12～24个月(平均16.5±0.5个月).术后早期疼痛得到完全或明显缓解,术后VAS平均2.8±0.9较术前平均7.5±1.2明显下降(t=11.425 P＜0.01).术后1个月疼痛改善率:优82例,良6例,有效3例,总优良率96.7％,有效率为100％.84例患者于术后6～24 h自觉停用止痛药,5例患者于术后3d停用止痛药,其余2例患者虽未停用,但用药剂量明显减少.结论 PVP是一种能有效地缓解OVCF所致疼痛的方法.%Objective To investigate the effect and mechanism of percutaneous vertebroplasty (PVP) treatment on the pain caused by osteoporotic vertebral compression fracture (OVCF). Methods From January 2008 to March 2011, 91 patients of osteoporotic thoracolumbar vertebral compression fracture with pain were treated by PVP, including 29 males and 62 females, aged between 56 and 97 years (mean, 69. 5 years). Through the visual analog scale (VAS) and analgesic taking time, the situation of patients with pain relief were evaluated before and after operation. Results All the patients were follow-up for 12-24 months (mean, 16. 5 ± 0. 5 months). The back pain were relieved completely or significantly after operation, the VAS was decreased from preoperative 7. 5 ± 1. 2 to postoperative 2. 8 ± 0. 9 with a significant difference (t=11. 425, P<0. 01). The pain improvement at one month after PVP was excellent in 82 cases, good in 6 and effective in 3, with excellent and good rate of 96. 7% , effective rate of 100%. Eighty-four cases were consciously stopped taking analgesics in 6-24 hours after operation, 5 cases in 3 days after operation. Although the remaining 2 cases did not to stop taking painkillers, but the dosage was significantly reduced. Conclusion PVP is a recommendable method which can effectively alleviate the pain caused by OVCF.
展开▼
