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经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折围手术期并发症分析

[Analysis of perioperative complications of percutaneous kyphoplasty for osteoporotic vertebral compression fracture].

作者信息

Gui Xian-Ge, Ru Xuan-Liang, Jiang Zeng-hui, Song Bo-Shan

出版信息

Zhongguo Gu Shang. 2013 Mar;26(3):205-9.

Abstract

OBJECTIVE

To analyze the perioperative complications of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture.

METHODS

From June 2009 to December 2011, 63 patients with osteoporotic vertebral compression fracture underwent PKP, there were 18 males and 45 females with an average age of 75.3 years ( ranged, 62 to 91). All patients with severe back pain and without neurological symptoms and signs, which were confirmed by X-ray and MRI. Among them,there were 63 cases with severe osteoporosis, 37 cases with hypertension, 10 with coronary artery disease, 29 with anemia, 26 with diabetes, 11 with chronic obstructive pulmonary diseases and 8 with gastritis and peptic ulcer. The common perioperative complications were retropectively reviewed.

RESULTS

Preoperative complications occured in 9 cases (14.3%), including hypostatic pneumonia (1 case), electrolyte disturbances (2 cases), urinary tract infection (2 cases), moderate anemia(2 cases),electrolyte disturbances combined with moderate anemia (1 case), hypostatic pneumonia combined with delirium (1 case). Intraoperative and postoperative. complications occurred in 17 cases (26.9%), there were bone cement correlated complications in 9 cases (14.3%), in which 2 cases of toxic reaction of bone cement and 7 cases of leakage (2 cases had clinical symptoms); there were non-bone cement correlated complications in 3 cases (4.8%), in which 1 case of focal hematoma caused by paracentesis, 1 case of transient nerve injury, 1 case of left intercostal neuralgia;there were transient hyperpathia in 5 cases after operation. All complications result in no severe consequence after treatment.

CONCLUSION

Perioperative complications of percutaneous kyphoplasty are not uncommon,however,these complications may not cause serious consequence after active treatment,so prevention and treatment are important for it.

摘要

目的

分析经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折的围手术期并发症。

方法

2009年6月至2011年12月,63例骨质疏松性椎体压缩骨折患者接受PKP治疗,其中男性18例,女性45例,平均年龄75.3岁(62~91岁)。所有患者均有严重背痛且无神经症状和体征,经X线和MRI证实。其中,重度骨质疏松63例,高血压37例,冠状动脉疾病10例,贫血29例,糖尿病26例,慢性阻塞性肺疾病11例,胃炎和消化性溃疡8例。回顾性分析常见的围手术期并发症。

结果

术前并发症9例(14.3%),包括坠积性肺炎1例、电解质紊乱2例、尿路感染2例、中度贫血2例、电解质紊乱合并中度贫血1例、坠积性肺炎合并谵妄1例。术中和术后并发症17例(26.9%),骨水泥相关并发症9例(14.3%),其中骨水泥毒性反应2例,渗漏7例(2例有临床症状);非骨水泥相关并发症3例(4.8%),其中穿刺引起局部血肿1例、短暂性神经损伤1例、左侧肋间神经痛1例;术后短暂性感觉异常5例。所有并发症经治疗后均未导致严重后果。

结论

经皮椎体后凸成形术围手术期并发症并不少见,然而,这些并发症经积极治疗后可能不会导致严重后果,因此预防和治疗很重要。

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