明胶海绵预注射在椎体成形术中预防骨水泥渗漏的体外研究

In vitro study on prevention of bone cement leakage with gelatin sponge pre-injection during percutaneous vertebroplasty operation

摘要:

目的：以离体椎体标本为对象，研究明胶海绵预注射在椎体成形术中预防骨水泥渗漏的效果。方法：选用老年女性尸体胸腰椎标本制成压缩骨折模型，随机分为单纯骨水泥组（A组）、明胶海绵预注射+单纯骨水泥（B组）。在19 ℃时测定2组骨水泥动态粘度后，在离体标本上模拟经皮椎体成形术（percutaneous vertebroplasty，PVP），骨水泥调和后取第3、6、9、12 min 4个时间点分别匀速缓慢推注5 ml骨水泥，分别测量每组骨水泥的渗漏率和渗漏量。结果：单纯骨水泥粘度随时间延长而增高，且加入明胶海绵对粘度有较大影响，B组骨水泥的粘度均要比A组高，差异具有统计学意义（P=0.000）。骨水泥调和后第9 min是较为适宜的灌注时间点，B组的渗漏量明显小于A组（P=0.035）。结论：传统低粘度骨水泥结合明胶海绵预注射的方法，可明显减少骨水泥渗漏率和渗漏量，较为经济，便于操作，具有良好的临床推广前景。

Abstract:

Objective：To evaluate the prevention of bone cement leakage with gelatin sponge pre-injection during percutaneous verte－broplasty（PVP） operation. Methods：The thoracolumbar samples from elderly female corpse were selected to make compression frac－ture models. The models were randomized into low viscosity bone cement group（group A） and gelatin sponge pre-injection plus low viscosity bone cement group（group B）. The bone cement dynamic viscosity under the temperature of 19 ℃ in both groups was esti－mated. Bone cement leakage rate and leakage quantity of each group were detected by using imitated percutaneous vertebroplasty （PVP） method and by separately injecting 5 ml bone cement at constantly slow speed at points of 3，6，9，12 min after the bone cement reconciliation. Results：The viscosity of low viscosity bone cement increased with the time while adding gelatin sponge exerted great impact on the viscosity. The viscosity of bone cement viscosity in group B was higher than that of group A，with statistical significant differences（P=0.000）. The appropriate time point for adding gelatin sponge was 9 min after cement mixing. The leakage quantity of group B was significantly fewer than that of group A（P=0.035）. Conclusion：The traditional method of combining low viscosity bone cement with gelatin sponge pre-injection can obviously decrease percolation rate and percolation quantity of the bone cement. This method is more economical，easier to operate and has a good prospect of clinical promotion.