唑来膦酸联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床研究
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篇名: 唑来膦酸联合经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床研究
TITLE:
摘要: 目的:探讨唑来膦酸注射液联合经皮椎体成形术对骨质疏松性椎体压缩骨折(OVCF)患者的临床效果及安全性。方法。选择2014年1月-2015年12月在我院进行治疗的OVCF患者130例,按随机数字表法分为观察组和对照组,各65例。对照组患者应用经皮椎体成形术注射骨水泥治疗,观察组患者在对照组基础上加用唑来膦酸注射液5 mg,ivgtt(滴注时间≥15 min),1年1次。两组患者术后均口服钙剂和维生素 D。观察两组患者治疗后1周、6个月的视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、日常生活能力量表(ADL)评分,检测两组患者治疗后1年的腰椎L1~L4和股骨颈的骨密度,并记录不良反应发生情况。结果:治疗前,两组患者VAS评分、ODI、ADL评分以及腰椎L1~L4和股骨颈的骨密度比较,差异均无统计学意义(P>0.05);治疗后1周、6个月,两组患者VAS评分、ODI显著降低,ADL评分显著升高,且观察组患者显著优于对照组,差异均有统计学意义(P<0.05);治疗后1年,观察组患者腰椎L1~L4和股骨颈的骨密度均显著增高,且观察组显著优于对照组,差异均有统计学意义(P<0.05)。两组患者发热、头晕、骨关节痛、肌肉软组织疼痛、新骨折等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:唑来膦酸联合经皮椎体成形术治疗OVCF能明显减轻患者疼痛,改善其功能障碍,增强骨密度,并具有较高的安全性。
ABSTRACT: OBJECTIVE: To explore the clinical effect and safety of Zoledronic acid injection combined with percutaneous vertebroplasty for osteoporotic vertebral compression fracture (OVCF). METHODS: A total of 130 OVCF patients selected from our hospital during Jan. 2014-Dec. 2015 were divided into observation group and control group according to random number table, with 65 cases in each group. Control group was given bone cement by percutaneous vertebroplasty. Observation group was additionally given Zoledronic acid injection 5 mg, ivgtt, once a year (dripping time ≥15 min), on the basis of control group. Both groups were given calcium and vitamin D orally after surgery. VAS scores, Oswestry disability index (ODI) and ADL scores were observed in 2 groups 1 week and 6 months after treatment. Bone density of lumbar vertebra L1-L4 and femoral neck were detected in 2 groups after one year of treatment. RESULTS: Before treatment, there was no statistical significance in VAS scores, ODI or ADL scores,bone density of lumbar vertebra LI-L4 and femoral neck between 2 groups (P>0.05). VAS scores and ODI of 2 groups were decreased significantly, while ADL scores were increased significantly 1 week and 6 months after treatment; observation group were significantly better than control group, with statistical significance (P<0.05). One year after treatment, bone density of lumbar vertebra L1-L4 and femoral neck in observation group were significantly higher than control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups as fever, dizziness, bone and joint pain, muscle soft tissue pain and new fracture (P>0.05). CONCLUSIONS: Zoledronic acid combined with percutaneous vertebroplasty in the treatment of OVCF can significantly relieve pain, improve dysfunction and enhance bone density with good safety.
期刊: 2017年第28卷第29期
作者: 余德涛,王雷,邢贞武
AUTHORS: YU Detao,WANG Lei,XING Zhenwu
关键字: 唑来膦酸;经皮椎体成形术;骨质疏松;椎体压缩骨折;临床效果;预后
KEYWORDS: Zoledronic acid; Percutaneous vertebroplasty; Osteoporosis; Vertebral compression fracture; Clinical effect; Prognosis
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