Objective To evaluate the incidence and risk factors of postoperative complications of osteopo-rotic vertebral compression fracture by employing evidence-based medicine method so as to provide basis for clinical treatment strategy. Methods Eligible literatures on vertebral body compression fractures treated with percutaneous kyphoplasty were retrieved through Chinese and English medicine database. Then the retrieved literatures were organized and analyzed. Results Two Chinese and ten English literatures were included in the study. According to the results, the percentage of subsequent fractures after kyphoplasty varied from 6. 5% to 26. 3 % . The risk factors related to adjacent fractures included bone density, cement leakage, and kyphotic angle, but the exact risk factors of subsequent vertebral fractures following kyphoplasty were still in dispute. Conclusion The major risk factors contributing to adjacent vertebral fractures were osteoporosis and cement leakage, and good operative technique and anti-osteoporosis treatment are the effective methods to reduce the incidence of subsequent vertebral fractures.%目的 评价不同治疗方法对连枷胸的临床疗效,优化治疗方案.方法 回顾性分析2005年~2010年我科收治的69例重度损伤合并连枷胸病人的临床资料,分成A组(加压包扎胸带外固定组)30例、B组(呼吸机内固定组)21例、C组(手术内固定组)18例,对3组治疗近、远期效果进行对比,以P<0.05为差异具有统计学意义.结果 与A组比较,B组呼吸、循环指标明显改善(P<0.001),肺感染率增高(P<0.05)、胸廓畸形率、活性药物使用率、ICU天数、总住院天数减少(P<0.05);C组呼吸、循环指标明显改善(P<0.001),肺感染率、胸廓畸形率、活性药物使用率、ICU天数、总住院天数减少(P<0.05).C组与B组比较,治疗后24h,呼吸、PaO2、PaCO2指标无统计学意义(P>0.05),C组循环指标更稳定,肺部感染率、胸廓畸形率、活性药物使用率、ICU天数、总住院天数减少具有统计学意义(P<0.05),C组快速促进肺功能恢复,A、B、C组死亡率无统计学差异.结论 手术治疗快速稳定胸壁,促使呼吸、循环稳定,减少并发症,减少住院时间,促进肺功能恢复,是连枷胸的理想治疗方法.
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