目的 比较唑来膦酸对 PVP(椎体成形术)治疗OVCF(骨质疏松椎体压缩性骨折)术后再发骨折的影响。方法 收集2016年12月—2018年6月在我院骨科接受PVP治疗患者共70例,其中40人在术后接受了唑来膦酸治疗(观察组),30人在术后接受了安慰剂治疗(对照组),两组患者均给予维生素D和钙剂基础治疗。记录术后6个月、1年、2年腰椎骨密度;术后2年内伤椎及邻近椎体再发骨折情况。结果 观察组伤椎再发骨折率(1/40,2.5%)低于对照组(2/30,6.67%)(P＜0.05);观察组邻椎再发骨折率(2/40,5%)低于对照组(7/30,23.33%)(P＜0.05)。结论 唑来膦酸能较好地预防PVP术后再发骨折。

Objective To compare the effect of zoledronic acid on the treatment of osteoporotic vertebral compression fracture after percutaneous vertebroplasty PVP. Methods From December 2017 to June 2019, a total of 70 patients who received PVP in the hospital medical plastic surgery clinic, 40 patients were collected received zoledronic acid (group A) and 30 patients received placebo (group B) after operation. Both groups received basic treatment of vitamin D and calcium. The bone mineral densits (BMD) of lumbar vertebrae were recorded at 6 months, 1 year and 2 years after operation, and the recurrent fractures of injured vertebrae and adjacent vertebrae were recorded at 2 years after operation. Results The rate of recurrent fracture of vertebrae in group A (1/40, 2.5%) was lower than that in group B (2/30, 6.67%); the rate of recurrent fracture of adjacent vertebrae in group A (2/40, 5%) was grcartly lower than that in group B (7/30, 23.33%). Conclusion Zoledronic acid can prevent recurrent fracture after PVP.

目的 探讨维生素D对维生素D缺乏患者ACCF术后钛网下沉及临床疗效的影响。方法 70例行ACCF术治疗的维生素D缺乏患者,按随机数字表法将患者分为对照组及观察组,每组35例。观察组患者术后即刻及出院后每月给予肌肉注射10万U维生素D₃,持续6个月,对照组患者则给予肌肉注射1 mL生理盐水。比较两组颈椎融合时间、钛网下沉率、术后1年颈椎JOA评分、NDI评分。结果 观察组术后1年颈椎JOA评分、NDI评分均优于对照组(均P＜0.05);观察组钛网下沉率低于对照组,颈椎融合时间短于对照组(均P＜0.05)。结论 补充维生素D可以缩短维生素D缺乏患者的ACCF术后融合时间、减少钛网下沉、改善临床疗效。

Objective To investigate the effect of vitamin D on titanium mesh subsidence and clinical efficacy in patients with vitamin D deficiency after ACCF. Methods Seventy patients with vitamin D deficiency treated by ACCF were divided into control group and observation group according to random number table method, 35 cases in each group. Patients in the observation group were given intramuscular injection of 100 000 U of vitamin D₃ immediately after operation and after discharge for 6 months, while patients in the control group were given intramuscular injection of 1 mL of normal saline. The time of cervical fusion, the subsidence rate of titanium mesh, the JOA score and NDI score of cervical spine 1 year after operation were compared between the two groups. Results The JOA score and NDI score of cervical vertebra in the observation group were better than those in the control group one year after operation(P<0.05);the subsidence rate of titanium mesh in the observation group was lower than that in the control group, and the fusion time of cervical vertebra was shorter than that in the control group(P<0.05). Conclusion Vitamin D supplementation may shorten the fusion time of patients with vitamin D deficiency after ACCF, reduce the sinking of titanium mesh and improve the clinical efficacy.