Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (24): 3918-3923.doi: 10.3969/j.issn.2095-4344.2017.24.025
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Sun Jing-hua, Ruan Wen-li, Zhao Xiao-ling, Chi Xiao-fei
Revised:
2017-04-22
Online:
2017-08-28
Published:
2017-08-30
About author:
Sun Jing-hua, Master, Associate chief physician, Department of Orthopedics, Dalian Second People’s Hospital, Dalian 116011, Liaoning Province, China
Supported by:
the Doctoral Scientific Research Foundation of Liaoning Province, No. 2013ED15F167
CLC Number:
Sun Jing-hua, Ruan Wen-li, Zhao Xiao-ling, Chi Xiao-fei. Two-year postoperative use of zoledronic acid prevents secondary fractures following percutaneous kyphoplasty[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(24): 3918-3923.
2.1 参与者数量分析 纳入患者186例,分为2组,按意向性处理分析,全部进入结果分析。 2.2 两组基线资料比较 两组患者基线资料比较见表1;两组患者分组流程图见图1。 2.3 手术情况 186例患者208个椎体行经皮椎体后凸成形术,水泥在椎体内弥散均匀。3例患者骨水泥外渗至椎体前缘或侧面2 mm处,但临床未见不良反应及不适。 2.4 功能障碍评分、骨密度、疼痛的变化情况 见表2。2组患者均获得随访,无失随访及排除病例。2组患者用药前Oswestry功能障碍指数、骨密度、视觉模拟量表比较差异无显著性意义(P > 0.05); 2组患者用药2年后随诊Oswestry功能障碍指数评分、骨密度、目测类比评分比较差异有显著性意义(P < 0.05);试验组和对照组患者用药2年后与本组用药前Oswestry功能障碍指数、骨密度、目测类比评分比较差异均有显著性意义(P < 0.05)。"
2.5 再骨折和二次手术情况 2年中试验组有1例患者因崴脚出现三踝骨折行手术治疗,对照组有9例因轻微外伤致临近椎体及跳跃椎骨折,T8椎体1例,T10椎体2例,T11及T12椎体各1例,L1椎体2例,L2椎体2例,7例再次行经皮椎体后凸成形术,1例患者因股骨颈骨折行全髋关节置换术。2组再骨折发生率比较差异有显著性意义(х2=3.88,P < 0.05)。 2.6 典型病例介绍 77岁女性患者,2010年8月16日术前诊断:L4压缩性骨折,行经皮椎体后凸成形术,术后单纯给与钙剂和阿法骨化醇,2011年4月8日T12椎二次骨折,再次行经皮椎体后凸成形术,见图2。 2.7 并发症 ①术中并发症:有3例患者出现骨水泥渗漏至椎体外或间盘组织中[10-11],1例出现球囊破裂,取出球囊病椎高度丢失2例,未出现神经损伤术后感染并发症;②术后并发症:1例患者术后出现过敏性皮疹,应用苯海拉明20 mg后症状消失;③应用唑来膦酸后不良反应:12例出现发热、流感症状或肌痛[12-13]。应用对乙酰氨基酚片后症状消失。"
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