经皮穿刺椎体成形术治疗骨质疏松性椎体压缩骨折并发症的分析与护理_West China Medical Journal

Authors：

 陈兰 ,  刘俐

四川大学华西医院疼痛科（成都 610041）;

Corresponding author：

刘俐, Email: liuli-hsy@163.com

Keywords：

经皮椎体成形术; 骨质疏松性椎体压缩骨折; 并发症; 护理

DOI：

10.7507/1002-0179.20160041

Video：

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目的探讨经皮穿刺椎体成形术（PVP）治疗老年人骨质疏松性椎体压缩骨折（OVCF）并发症的观察与护理，为临床护理工作提供参考。方法对2011年1月-2013年10月70例OVCF患者120节椎体行PVP治疗，观察并记录围术期相关并发症，分析其原因及预防措施，并总结其护理经验。结果术后发生并发症21例，其中穿刺部位疼痛6例，骨水泥渗漏6例（其中椎体引流静脉3例，邻近椎间盘2例，穿刺侧椎弓根1例），临近椎体压缩骨折4例，原有疼痛短暂加重2例，肺栓塞1例，发热1例，一过性血压降低1例。术后疼痛缓解[视觉模拟评分VAS（3.12±1.16）分]与术前[VAS（6.39±1.19）分]比较，差异有统计学意义（P＜0.05）。结论 PVP是治疗骨质疏松性椎体压缩骨折的有效方法，通过相应的护理措施，可以有效地降低其发生率，提高手术成功率，降低手术风险。

Citation： 陈兰, 刘俐. 经皮穿刺椎体成形术治疗骨质疏松性椎体压缩骨折并发症的分析与护理. West China Medical Journal, 2016, 31(1): 145-147. doi: 10.7507/1002-0179.20160041 Copy

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10.	Ryu KS, Park CK, Kim MC, et al. Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients w ith osteoporotic vertebral compression fractures[J]. J Neurosurg, 2002, 96(1):56-61.
11.	Mirovsky Y, Anekstein Y, Shalmon E, et al. Intradiscal cement leak following percutaneous vertebroplasty[J]. Spine (Phila Pa 1976), 2006, 31(10):1120-1124.
12.	Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty[J]. Spine (Phila Pa 1976), 2001, 26(14):1547-1554.
13.	Molloy S, Mathis JM, Belkoff SM. The effect of vertebral body percentage fill on mechanical behavior during percutaneous vertebroplasty[J]. Spine (Phila Pa 1976), 2003, 28(14):1549-1554.
14.	申丽, 刘艳晶. 经皮椎体后凸成形术并发症的观察与护理[J]. 护理研究, 2012, 26(5):443-444.

1. Melton LJ, Iii KS, Frye MA, et al. Epidemiology of vertebral fractures inwomen[J]. Am J Epidemiol, 1989, 129(5):1000-1011.
2. Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures:technical aspects[J]. AJNR Am J Neuroradiol, 1998, 18(10):1897-1904.
3. Rapado A. General management of vertebral fractures[J]. Bone, 1996, 18(3 Suppl):191S-196S.
4. 孙燕. 我国试行的肿瘤患者生活质量评分//孙燕, 顾慰萍. 癌症三阶梯止痛指导原则[M]. 北京:北京医科大学出版社, 2002: 100-101.
5. Shapiro S, Abel T, Purvines S. Surgical removal of epidural and intradural polymethylmethacrylate extravasation complicating percutaneous vertebroplasty for an osteoporotic lumbar compression fracture. Case report[J]. J Neurosurg, 2003, 98 (1 Suppl1):90-92.
6. 罗春. 经皮椎体成形术20例护理体会[J]. 医学信息:中旬刊, 2010, 5(2):288-290.
7. Uppin AA, Hirsch JA, Centenera LV, et al. Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis[J]. Radiology, 2003, 226(1):119-124.
8. 徐靓. 经皮椎体成形术治疗椎体压缩性骨折的护理[J]. 当代护士:专科版, 2008(12):35-36.
9. Vasconcelos C, Gailloud P, Martin JB, et al. Transient arterial hypotension induced by polymethylmethacrylate injection during percutaneous vertebroplasty[J]. J Vasc Interv Radiol, 2001, 12(8):1001-1002.
10. Ryu KS, Park CK, Kim MC, et al. Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients w ith osteoporotic vertebral compression fractures[J]. J Neurosurg, 2002, 96(1):56-61.
11. Mirovsky Y, Anekstein Y, Shalmon E, et al. Intradiscal cement leak following percutaneous vertebroplasty[J]. Spine (Phila Pa 1976), 2006, 31(10):1120-1124.
12. Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty[J]. Spine (Phila Pa 1976), 2001, 26(14):1547-1554.
13. Molloy S, Mathis JM, Belkoff SM. The effect of vertebral body percentage fill on mechanical behavior during percutaneous vertebroplasty[J]. Spine (Phila Pa 1976), 2003, 28(14):1549-1554.
14. 申丽, 刘艳晶. 经皮椎体后凸成形术并发症的观察与护理[J]. 护理研究, 2012, 26(5):443-444.

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经皮穿刺椎体成形术治疗骨质疏松性椎体压缩骨折并发症的分析与护理

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