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目的:探讨经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)结合唑来膦酸注射液治疗老年女性骨质疏松性脊柱压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床应用价值。方法91例骨质疏松性椎体压缩骨折患者PVP术后根据临床评估及患者意愿分为49例唑来膦酸注射液治疗组(简称治疗组)和42例非唑来膦酸注射液治疗组(简称对照组),分析两组患者PVP术前、术后半年及一年的腰椎及桡骨远端骨密度变化,并采用10分制视觉模拟评分(VAS)对两组患者PVP术前、术后1月及6月进行疼痛变化的评价比较。观察术后脊椎再发骨折的发生率。结果:治疗组经唑来膦酸注射液治疗半年及1年后,患者的腰椎和桡骨远端骨密度值均增高,与对照组比较有统计学意义。PVP术后1月和术后6月,与对照组比较,治疗组患者VAS评分值均降低,差异具有统计学意义。治疗组患者发生椎体再骨折的风险为4.08%,与对照组相比,椎体再骨折风险显著降低70%。结论:PVP结合唑来膦酸注射液治疗能有效的改善疼痛,提高患者的骨密度,减少患者脊椎再发骨折的几率。
Objective: To investigate the clinical value of percutaneous vertebroplasty (PVP) combined with zoledronic acid in the treatment of osteoporotic vertebral compression fracture (OVCF) in elderly women. Methods 91 patients with osteoporotic vertebral compression fractures were divided into 49 cases of zoledronic acid injection treatment group (referred to as the treatment group) and 42 cases of non-zoledronic acid injection treatment group according to clinical assessment and patient’s wishes. (Control group). The changes of lumbar vertebral and distal radius mineral density in two groups before and after PVP for six months and one year after surgery were analyzed. Ten-point visual analogue scale (VAS) After January and June for pain evaluation comparison. The incidence of recurrent spine fractures was observed. Results: After treatment with zoledronic acid for 6 and 1 year in the treatment group, the BMD of the lumbar vertebrae and distal radius of the patients in the treatment group were significantly higher than those in the control group. Compared with the control group, the VAS score of the patients in the treatment group decreased at 1 month and 6 months after PVP, the difference was statistically significant. In the treatment group, the risk of vertebral body fractures was 4.08%, and the risk of vertebral body fractures was significantly reduced by 70% compared with the control group. Conclusion: PVP combined with zoledronic acid injection can effectively improve the pain, improve the patient’s bone mineral density and reduce the probability of spondylolisthesis.