目的：骨水泥血管内渗漏是导致经皮椎体成形术(percutaneous vertebroplasty, PVP)严重并发症肺栓 塞的主要原因，如何减少血管性渗漏的发生一直是临床医师关注的热点，本研究通过观察PVP术 中采用不同注射位点时骨水泥渗漏的发生，从而探讨其对骨水泥血管性渗漏发生的影响。方法： 2009年6月~2014年6月，采用PVP治疗66例骨质疏松性椎体压缩性骨折患者，男18例，女48例； 年龄56~92岁，平均71.2岁；均为骨质疏松性椎体压缩性骨折，共71个椎体，根据骨水泥的注射 位点不同分为两组：A组，36个椎体在PVP术中注射位点定于椎体的下二分之一；B组，35个椎体 在PVP术中注射位点定于椎体的上二分之一。根据术中单个椎体骨水泥注入量、X线观察骨水泥 血管性渗漏及术后中远期疗效进行两组间的对照研究。结果：71个椎体共11个椎体发生血管性渗 漏。A组2个椎体发生骨水泥血管性渗漏，渗漏率为5.56%；B组9个椎体发生骨水泥血管性渗漏， 渗漏率为25.76%，且A组在骨水泥的注入量及术后远期疗效要优于B组，两组间差别有统计学意义 (P<0.05)。结论：PVP注射位点位于下半椎体时能降低骨水泥血管性渗漏发生风险，且术后中远期 疗效更佳。
A correlation study between insertion site of bone cement and vascular leakage and curative effect in percutaneous vertebroplasty
Objective: Vascular bone cement leakage is a major cause of lead to pulmonary embolism, the serious complication of percutaneous vertebroplasty (PVP). How to reduce the occurrence of vascular leakage has been a hot topic of clinical physician. In this study, by observing the occurrence of bone cement leakage during the percutaneous vertebroplasty of using different injection sites, thus discussing the influence on the occurring of vascular bone cement leakage. Method: From June 2009 to June 2014, included 66 osteoporotic vertebral compression fracture patients in percutaneous vertebroplasty, 18 males and 48 females (60-82 years, average 71.2 years old), a total of 71 vertebral bodies. The bone cement insertion site of group A (36 vertebral bodies) is lower half of vertebral body, the insertion site of group B (35 vertebral bodies) is upper half of vertebral body. According to the injection volume of bone cement, the X-ray to analyse vascular leakage of bone cement and postoperative long-dated curative effect. Result: Vascular leakage of 11 vertebral bodies was happened. The incidence of vascular leakage is 5.56% in group A (2 vertebral bodies), the incidence of vascular leakage is 25.76% in group B (9 vertebral bodies). The injection volume of bone cement and postoperative long-dated curative effect in group A is better than that of group B. There was statistical difference between the two groups (P<0.05). Conclusion: The risk of incidence of vascular leakage could be reduced and the postoperative long-dated curative effect could be better when the insertion site was located in the lower half of vertebral body.