|本期目录/Table of Contents|

[1]唐永亮,张静怡.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[J].医学研究与战创伤救治(原医学研究生学报),2017,19(02):145-149.[doi:10.3969/j.issn.1672-271X.2017.02.008]
　TANG Yong-liang,ZHANG Jing-yi.Application value of PVP surgery combined with alendronate sodium treatment in improving dysfunction of patients with osteoporotic vertebral compression fractures[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(02):145-149.[doi:10.3969/j.issn.1672-271X.2017.02.008]
点击复制

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()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年02期
页码:
145-149
栏目:
出版日期:
2017-03-20

文章信息/Info

Title:
Application value of PVP surgery combined with alendronate sodium treatment in improving dysfunction of patients with osteoporotic vertebral compression fractures
作者:
唐永亮1; 张静怡2
1. 710003西安，西安市中心医院骨二科;2. 330006南昌, 南昌大学第一临床医学院
Author(s):
TANG Yong-liang1;  ZHANG Jing-yi2
(1. Second Department of Orthopedics, Xi′an Central Hospital, Xi′an 710003, Shaanxi, China; 2. the First Clinical Medical College of Nanchang University，Ｎａｎｃｈａｎｇ ３３０００６，Jiangxi,Ｃｈｉｎａ)
关键词:
经皮椎体成形术; 阿仑膦酸钠; 骨质疏松性椎体压缩骨折; 疗效; 功能障碍
Keywords:
Percutaneous vertebroplasty;  Alendronate sodium;  Osteoporotic vertebral compression fractures;  Dysfunction;  Curative effect
分类号:
R687.3
DOI:
10.3969/j.issn.1672-271X.2017.02.008
文献标志码:
A
摘要:
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。
Abstract:
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 patient′s 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 patient′s dysfunction, and it′s worth for further clinical promotion.

参考文献/References:

[1]Mclnnes IB, Kim HY, Lee SH, et al. Open-label tofaeitinib and double-blind atorvastatin in rheumatoid arthritis patients: a randomised study[J]. Ann Rheum Dis,2014, 73(1): 124-131.
[2]李自强,杜科伟,杜夏铭,等.椎体成形术与椎体后凸成形术治疗骨质疏松性椎体压缩性骨折发生骨水泥渗漏的相关临床评价[J].解放军医药杂志,2016,28(5):54-58.
[3]熊明月,刘立强,刘振辉,等.阿仑膦酸钠联合低分子肝素钙治疗老年骨质疏松性骨折的临床效果分析[J].中国生化药物杂志,2014(5):118-120.
[4]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊治指南(2011年)[J].中华骨质疏松和骨矿盐疾病杂志,2011,4(1):2-17.
[5]张宏,任虎,冯涛,等.高粘度骨水泥椎体成形术与球囊扩张椎体成形术治疗骨质疏松性椎体压缩骨折疗效对比分析[J].解放军医药杂志,2016,28(6):62-65.
[6]Particelli F,Mecozzi L,Beraudi A. A comparison between micro-CT and histology for the evaluation of corical bone:effect of polymethylmethacrylate embedding on structural parameters[J].J Microsc,2012,245(3):302-310.
[7]方贺,何芳明,傅英华,等.阿仑膦酸钠治疗骨质疏松性脊柱压缩性骨折椎体成形术后残余疼痛的早期疗效观察[J].中国生化药物杂志,2015,35(10):35-37.
[8]杜宇康,廖瑛扬,肖淼盛,等.经皮椎体成形术与经皮椎体后突成形术治疗骨质疏松性椎体压缩骨折的疗效对比分析[J]. 中国矫形外科杂志,2014,22(10):946-948.
[9]Balkarli H, Demirtas H, Kilic M, et al. Treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty under local anesthesia: clinical and radiological results [J]. Int J Clin Exp Med, 2015, 8 (9): 16287-16293.
[10]秦虎，何斌，王云华，等. 手法复位结合经皮椎体后凸成形术治疗老年新鲜骨质疏松性椎体压缩性骨折的研究[J].医学研究生学报,2015,28(4):385-389.
[11]张长春,朱坤,周建生,等. 经皮椎体成形术和经皮椎体后凸成形术治疗老年女性胸腰椎移行处单椎体骨质疏松性压缩性骨折对邻接椎体骨密度的影响[J].中国老年学杂志,2014,34(20):5741-5743.
[12]Balkarli H, Demirtas H, Kilic M, et al. Treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty under local anesthesia clinical and radiological results[J]. Int J Clin Exp Med，2015,8(9): 16287-16293.
[13]包拥政,祝周兴,冯云升,等.低弹性模量骨水泥对骨质疏松压缩性骨折椎体及邻近椎体应力的影响：三维有限元分析[J].中国组织工程研究,2016,20(16):2285-2293.
[14]吴鹏,王博,孔令成,等.强骨饮颗粒联合阿仑膦酸钠维 D3片口服在原发性骨质疏松性髋部骨折术后抗骨质疏松治疗中的应用[J].中医正骨,2016,28(5):16-19.
[15]Zhang ZL,Liao EY,Xia WB,et al.Alendronate sodium/vitamin D3 combination tablet versus calcitriol for osteoporosis in Chinese postmenopausal women:a 6-month,randomized,open-label,active-comparator-controlled study with a6-month extension[J]. Osteoporos Int,2015,26(9):2365-2374.
[16]杨雪骅,陈志君,左权,等.阿仑膦酸钠、阿法骨化醇、碳酸钙联合应用治疗糖皮质激素诱发的骨质疏松症32例疗效分析[J].上海医药,2014,35(1):28-31.
[17]Khan A,Dubois S,Khan AA,et al.A randomized,doubleblind,placebo-controlled study to evaluate the effects of alendronate on bone mineral density and bone remodelling in perimenopausal women with low bone mineral density[J].J Obstet Gynaecol Can,2014, 36(11): 976-982.
[18]覃裕,邱冰,朱思刚,等.唑来膦酸与阿仑膦酸钠治疗骨质疏松患者的疗效比较及对血清25-(OH) D、BALP、BGP的影响分析[J].中国骨质疏松杂志,2016,22(8):1035-1038.
[19]Cosman F, Keaveny TM, Kopperdahl D, et al. Hip and spinestrength effects of adding versus switching to teriparatide in post-menopausal women with osteoporosis treated with prior alendr-onate or raloxifene [J]. J Bone Miner Res,2013,28(6): 1328-1336.
[20]Borromeo GL, Brand C, Clement JG, et al. A large case-controlstudy reveals a positive association between bisphosphonate useand delayed dental healing and osteonecrosis of the jaw[J].J Bone Miner Res, 2014, 29(6): 1363-1368.
[21]Muschitz C, Kocijan R, Fahrleitner-Pammer A, et al. Overlap-ping and continued alendronate or raloxifene administration in pa-tients on teriparatide: effects on areal and volumetric bone miner-al density-the CONFORS study [J]. J Bone Miner Res, 2014, 29(8): 1777-1785.

相似文献/References:

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2017-03-20