经皮椎体成形术后结合阿仑膦酸钠治疗在改善骨质疏松性椎体压缩骨折患者功能障碍中的应用

摘要

Objective To discuss the application value of percutaneous vertebroplasty(PVP surgery)combined with alendronate sodium treatment in improving dysfunction of patients with osteoporotic vertebral compression fractures.Methods 100 patients with osteoporotic vertebral compression fractures were selected from September 2013 to September 2016 in our Hospitals.According to the random distribution,all patients were divided into combination group and conventional group,50 cases in each group.The conventional group of patients were given conventional PVP treatment and postoperative diet,exercise and other direct intervention,and the combination group of patients on the basis were given 70 mg of Allen phosphonic acid sodium oral treatment,1 time per week.The e-linked immunosorbent(ELISA)was used to detect serum osteocalcin(BGP),alkaline phosphatase(ALP),urine deoxidization pyridine(DPD);the method of visual analogue scale(VAS)was used to assess pain degree;the Oswestry disability index questionnaire(ODI)was used to assess the dysfunction degree.Patients were followed up for 6 months,and statistical analysis was performed with the clinical curative effect,before and before treatment and after treatment serum BGP and ALP,DPD level,Cobb Angle,fanterior flange height,lumbar bone mineral density,1,3,6 months after treatment level of pain and quality of life on all patients.Results The treatment efficiency rate of the combination group of patients was significantly higher than that of the conventional group (P＜0.05);The serum BGP level after treatment of the combination group of patients was significantly higher than that of the conventional group, and the serum ALP, DPD level after treatment of the former were significantly lower than those of the latter (P＜0.01);The Cobb Angle, fanterior flange height, lumbar bone mineral density levels after treatment of the combination group were significantly higher than that of the conventional group (P＜0.01);The VAS and ODI score after treatment of 1, 3, 6 months of the combination group were significantly lower than those of the conventional group (P＜0.01).Conclusion PVP surgery combined with alendronate sodium treatment can effectively improve the treatment of patients with osteoporotic vertebral compression fractures curative effect, and it can effectively improve the patients Cobb Angle, fanterior flange height, lumbar bone mineral density and bone metabolism.It is conducive to alleviate the pain of patients with symptoms and improve the patients dysfunction, and its worth for further clinical promotion.%目的 探讨经皮椎体成形术(PVP术)后结合阿仑膦酸钠治疗在改善骨质疏松性椎体压缩骨折患者功能障碍中的应用价值.方法 选取2013年9月至2016年9月期间确诊治疗的骨质疏松性椎体压缩骨折患者100例,依据随机数表法随机分为结合组和常规组,每组50例,常规组患者给予常规PVP术治疗和术后饮食、运动等指导干预,结合组患者在此基础上给予70mg阿仑膦酸钠口服治疗,1次/周,采用酶联免疫吸附法(ELISA)检测血清骨钙素(BGP)、碱性磷酸酶(ALP)、尿脱氧吡啶酚(DPD),采用视觉模拟评分法(VAS)评估疼痛程度,采用Oswestry功能障碍指数问卷表(ODI)评估功能障碍程度,随访6个月,统计分析所有患者临床疗效、治疗前后血清BGP、ALP、DPD水平、Cobb角、椎体前缘高度、腰椎骨密度,以及治疗前、治疗后1、3、6个月的疼痛程度和生活质量情况.结果 结合组患者治疗有效率明显高于常规组(P＜0.05);结合组患者治疗后血清BGP水平明显高于常规组,血清ALP、DPD水平明显低于常规组,差异有统计学意义(P＜0.01);结合组患者治疗后Cobb角、椎体前缘高度、腰椎骨密度水平均明显高于常规组(P＜0.01);结合组患者治疗后1、3、6个月的VAS和ODI得分明显低于常规组(P＜0.01).结论 PVP术后结合阿仑膦酸钠治疗可有效提高骨质疏松性椎体压缩骨折患者的治疗疗效,有效改善患者的Cobb角、椎体前缘高度、腰椎骨密度及骨代谢,有利于缓解患者的疼痛症状和改善患者的功能障碍,值得临床进一步推广.