PKP联合唑来膦酸治疗骨质疏松性椎体压缩骨折的疗效分析
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摘要
目的探讨经皮椎体后凸成形术(PKP)联合唑来膦酸治疗骨质疏松性椎体压缩骨折的疗效。方法纳入自2016-10—2017-10采用PKP联合唑来膦酸治疗30例骨质疏松性椎体压缩骨折(观察组),并选取同期单纯行PKP治疗的42例骨质疏松性椎体压缩骨折(对照组)进行比较分析。结果观察组静脉滴注唑来膦酸后出现8例发热、鼻塞等流感样症状,3例关节痛、肌肉痛,在3～5 d内自行缓解。72例均获得至少1年随访,随访期间观察组未出现严重肝肾功能损伤、恶性心率失常、下颌骨坏死等并发症。观察组术后12个月疼痛VAS评分低于对照组,髋臼骨密度高于对照组,随访期间再次骨折发生率明显低于对照组,差异有统计学意义(P <0.05)。结论 PKP治疗骨质疏松性椎体压缩骨折可有效缓解患者腰背痛,创伤小、术后恢复快,术后联合唑来膦酸静脉滴注可减少骨量流失,增加骨密度,降低再骨折风险。
引文
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[7]Nourinia R,Ahmadieh H,Rezaei-Kanavi M,et al.Safety of intravitreal zoledronic acid,an anti-angiogenic bisphosphonate,in a rat model[J].J Ophthalmic Vis Res,2014,9(1):44-49.
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[9]Lyles KW,Colon-Emeric CS,Magaziner JS,et al.Zoledronic acid and clinical fractures and mortality after hip fracture[J].N Engl JMed,2007,357(18):1799-1809.
[10]梁文清,钱宇,郦仕杰,等.唑来膦酸对骨质疏松性椎体压缩骨折PKP术后疗效的影响[J].中国骨与关节损伤杂志,2015,30(9):926-929.
[2]Cummings SR,Melton LJ.Epidemiology and outcomes of osteoporotic fractures[J].Lancet,2002,359(9319):1761-1767.
[3]Yokoyama K,Kawanishi M,Yamada M,et al.Postoperative change in sagittal balance after Kyphoplasty for the treatment of osteoporotic vertebral compression fracture[J].Eur Spine J,2015,24(4):744-749.
[4]Magremanne M,Reychler H.Pentoxifylline and tocopherol in the treatment of yearly zoledronic acid-related osteonecrosis of the jaw in a corticosteroid-induced osteoporosis[J].J Oral Maxillofac Surg,2014,72(2):334-337.
[5]杨惠林,刘强,唐海,等.骨质疏松性椎体压缩性骨折患者抗骨质疏松规范化治疗专家共识[J].中华医学杂志,2018,98(11):803-807.
[6]颜廷振,张晶,魏彦春,等.唑来膦酸联合骨水泥技术治疗老年骨质疏松性骨折的疗效分析[J].中国骨质疏松杂志,2014,20(2):192-195.
[7]Nourinia R,Ahmadieh H,Rezaei-Kanavi M,et al.Safety of intravitreal zoledronic acid,an anti-angiogenic bisphosphonate,in a rat model[J].J Ophthalmic Vis Res,2014,9(1):44-49.
[8]Boonen S,Black DM,Colon-Emeric CS,et al.Efficacy and safety of a once-yearly intravenous zoledronic acid 5 mg for fracture prevention in elderly postmenopausal women with osteoporosis aged 75 and older[J].J Am Geriatr Soc,2010,58(2):292-299.
[9]Lyles KW,Colon-Emeric CS,Magaziner JS,et al.Zoledronic acid and clinical fractures and mortality after hip fracture[J].N Engl JMed,2007,357(18):1799-1809.
[10]梁文清,钱宇,郦仕杰,等.唑来膦酸对骨质疏松性椎体压缩骨折PKP术后疗效的影响[J].中国骨与关节损伤杂志,2015,30(9):926-929.