宋海涛;张伟;李民;高卫良;吴玉泉;曲邵政;刘彦斌;盛文博;

• 1:中国人民解放军第一○七医院脊柱外科

摘要(Abstract)：

[目的]分析经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年骨质疏松性椎体骨折(osteoporotic vertebral compression fractures,OVCFs)过程中的并发症,探讨发生原因及预防对策。[方法]回顾性研究2013年12月～2017年12月,采用PKP治疗OVCFs患者577例共621个椎体。将并发症的发生以骨水泥注入椎体内为时间节点,分为骨水泥注射前并发症、骨水泥注射过程中并发症及骨水泥注射后遗留并发症三种情况,术后随访2～31个月,平均(18.42±2.43)个月。[结果]骨水泥注入量胸椎平均(3.60±1.50)ml,腰椎平均(5.80±1.90)ml;共出现各种并发症89例,总体发生率为15.42%,其中在骨水泥注射前发生10例(11.24%):局麻导致全脊髓麻醉1例,穿刺导致脊髓休克1例、肋间神经不完全损伤3例、肋骨骨折1例、脑脊液漏1例、球囊扩张过程中一过性高血压3例;注射期间发生65例(73.03%):骨水泥渗漏到椎体外52例,呼吸困难、血压下降8例,一过性疼痛加重5例;注射后期发生14例(15.73%):骨水泥拖尾导致局部异物感4例,疼痛症状加重3例,术后发热7例;各种并发症中以骨水泥渗漏相关并发症最为多见,占比58.43%(52/89);发生并发症后紧急后路椎板切除神经减压2例、手术延期6例、暂停翻身观察后继续手术11例、对症处理16例。[结论]应用PKP治疗OVCFs除应关注骨水泥渗漏的并发症外,还应重视围骨水泥灌注期的并发症,给予积极预防和及时处置。

关键词(KeyWords)： 骨质疏松症;椎体压缩骨折;经皮椎体后凸成形术;骨水泥灌注;并发症

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 宋海涛;张伟;李民;高卫良;吴玉泉;曲邵政;刘彦斌;盛文博;

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