不同方法治疗胸腰段骨折临床观察  

Clinical Observation on Operative or Non operative Treatment to the Burst Fractures of Thoracolumbar Spine

作　　者：林研[1] 印心奇[1] 徐根宝[1] 吴韦[1] 孙万驹[1] 尹峰[1] 周炜[1] 李旭[1] 

机构地区：[1]上海市东方医院,浦东南路551号200120

出　　处：《中国矫形外科杂志》2000年第6期534-537,共4页Orthopedic Journal of China

摘　　要：目的 :临床应用对照研究的方法来比较和评价保守治疗、外科手术治疗胸腰段骨折。方法 :1995年 7月～1998年 6月本院收治胸腰段单一节段 (T11～L2 )爆裂骨折病人随机分组为手术组H (Harrington棒复位固定 )、手术组D(Dick钉复位固定 )、保守治疗组C(卧床后支具保护 )。共 70例。获随访 5 8例 ,其中手术组 (H) 16 ;手术组 (D) 16 ;保守组(C) 2 6随访比较一年。结果 :手术与非手术组病人术后主观评分都比较满意 (P >0 .2 )。受伤椎体观察提示 ,保守组几无良好复位 ,手术组 (H)复位明显较好 ,与保守组有显著差异 (P <0 .0 1)。手术组 (D)复位效果差 ,与保守组区别不明显 (P>0 .2 ) ,比手术组 (H)差 ,有显著差异 (P <0 .0 1)。结论 :作者认为胸腰段不稳定骨折可以采用保守治疗 ,但复位固定效果较差 ;手术复位固定效果明显 。Objective: Using clinical prospective study to compare operative and non operative treatments for the burst fractures of thoracolumbar spine. Methods: 70 patients who were diagnosed with the burst thoracolumbar fractures from July 1995 to June 1998 were divided into 3 groups randomly. There were Group H(operative reduction and fixation with Harrington rods), Group D(operative reduction and fixation with Dick instruments) and Group C(non operative reduction with Jewett braces taken). 58 patients were followedup for one year after treatment,including 26 in Group C, 16 in Group H and 16 in Group D. Result: Although all three groups patients were satisfied at the result objectively,significant differences could be obviously seen both on the X ray and CT. Group H had an excellent reduction, Group D worse and Group C worst. Conclusion: We recommend that non-operative treatment can be chosen but the effect of reductionis bad. Operative treatment is better because of its reduction and harrington rods has more satisfactory reduction.

关 键 词：胸腰段骨折 治疗 临床研究 

分 类 号：R683.2[医药卫生—骨科学]