An experimental study of percutaneous vertebroplasty using instruments and drugs made in China
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1005-1201.2003.03.002
- Key Word:
- 放射学,介入性;椎体成形术;植入物,实验性;聚甲基丙烯酸类
Abstract： 目的探讨国产药械行经皮椎体成形术(PVP)的可行性,为临床应用提供数据与指标.方法国产骨水泥(PMMA)按粉(g)/液(ml)比例2∶1、3∶2、1∶1配制分组;另外在PMMA中加入静脉用非离子型对比剂,以增加其在X线下的显影,按粉(g)/液(ml)/对比剂(ml)比例2∶1∶1、3∶2∶1、1∶1∶1配制分组;共6组,6份/组.分别测量各组的物料状态时期及产热温度.将各组PMMA制成直径1.0 cm,高3 cm的圆柱状,行X线摄片,测量其密度,并行抗压强度测试.对3具经甲醛溶液浸泡的正常成年男性尸体胸腰段躯干部分(T3～S1)模拟PVP操作,自T4至L4在透视监测下间隔椎体用国产穿刺针经椎弓根穿刺,每具尸体穿刺7个椎体,共穿刺21个椎体,并在透视监视下注射PMMA,记录各椎体的注射量.注射PMMA后,分别游离尸体椎体,将注射PMMA的椎体与邻近的下一个未注射PMMA的椎体作为一对,共21对标本;以同一尸体为单位,注射PMMA的椎体为实验组,未注射PMMA的椎体为对照组进行最大抗压强度测试.结果加入对比剂后不同比例组PMMA在固化期的产热均显著降低,3∶2∶1组的平均温度为67.4℃.经X线摄片的密度测量,加入对比剂的各组较未加入对比剂的各对应组不透X线特性显著增强(t值分别为20.00, 20.00, 22.86;P值均＜0.001),但加入对比剂的各组密度差异无显著性意义(t值分别为1.11, 1.18, 0.59;P值均 > 0.05).3∶2∶1比例组的浆糊期为(127±4.70) s,最大抗压强度(mPa)为47.23.尸体模拟PVP操作,均1次性穿刺成功,无椎弓根骨折,胸腰椎PMMA的平均注射量分别为5 ml与7.5 ml, 3个椎体出现PMMA外溢. 3组未注入PMMA椎体的最大抗压强度(mPa)分别为3.28,3.63,3.69;3组注入PMMA椎体的最大抗压强度(mPa)分别为4.52,4.73,4.81;注入PMMA椎体的最大抗压强度显著高于对照组(t值分别为3.17,3.55,3.99;P值均＜0.01).结论国产药械行椎体成形术是安全可行的,国产骨水泥(PMMA)3∶2∶1比例组的物料状态时期与最大抗压强度适宜于PVP.
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