改良颅骨牵引弓在颅骨牵引术中的应用  

APPLICATION OF MODIFIED TRACTION ARCH OF SKULL IN SKULL TRACTION

作　　者：雷星[1] 王焕[2] 宋扬[3] 曲彦隆[2] 

机构地区：[1]临沂市人民医院骨科,山东临沂276000 [2]哈尔滨医科大学附属第一医院骨科 [3]哈尔滨医科大学附属第二医院骨科

出　　处：《中国修复重建外科杂志》2014年第12期1474-1478,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：黑龙江省自然科学基金资助项目(D201112);临沂市科技发展计划资助项目(201413014);哈尔滨医科大学附属第一医院科研基金资助项目(2013704)~~

摘　　要：目的通过与传统颅骨牵引弓比较,探讨采用改良颅骨牵引弓(横杆牵引弓)行颅骨牵引治疗颈椎损伤的可行性以及疗效。方法 2009年6月-2013年6月,对90例颈椎骨折或脱位患者分别采用横杆牵引弓(试验组,n=45)以及传统颅骨牵引弓(对照组,n=45)进行颅骨牵引术。两组患者性别、年龄、损伤类型及节段、受伤至入院时间及脊髓损伤分级比较,差异均无统计学意义(P>0.05),具有可比性。记录并比较两组牵引弓滑脱次数、手术时间、针道感染例数、颅骨穿孔例数、手术渗血量、牵引术后72 h内疼痛视觉模拟评分(VAS)以及颈椎脱位患者复位情况。结果与对照组相比,试验组牵引弓滑脱次数、针道感染例数、手术时间以及手术渗血量均显著降低(P<0.05);两组仅颅骨穿孔例数比较,差异无统计学意义(P=1.000)。术后各时间点试验组VAS评分显著低于对照组,比较差异均有统计学意义(P<0.05)。术后2周内两组患者均无头痛、感染等并发症发生。颈椎脱位患者中,除试验组4例、对照组6例未复位外,其余均获复位,两组复位成功率分别为83.33%(20/24)以及68.42%(13/19),比较差异无统计学意义(χ2=0.618,P=0.432)。结论采用横杆牵引弓行颅骨牵引治疗颈椎损伤可行,与传统颅骨牵引弓相比,其在减少术后并发症方面具有显著优势。Objective To investigate the feasibility and effectiveness of the modified traction arch of skull（crossbar traction arch） for skull traction in treating cervical spine injury by comparing with traditional traction arch of skull.Methods Between June 2009 and June 2013,90 patients with cervical vertebrae fractures or dislocation were treated with modified skull traction surgery（trial group,n=45） and traditional skull traction surgery（control group,n=45）.There was no significant difference in gender,age,injury types,injury level,the interval between injury and admission,and Frankel grading of spinal injury between 2 groups（P〉0.05）.The clinical efficacy was evaluated after operation by the indexes such as traction arch slippage times,operation time,the infection incidence of the pin hole,incidence of skull perforation,visual analogue scale（VAS）,and reduction status of cervical dislocation.Results The traction arch slippage times,the infection incidence of the pin hole,operation time,blood loss,and postoperative VAS score in trial group were significantly lower than those in control group（P〈0.05）.There was no significant difference in the incidence of skull perforation caused by clamp crooks of traction arch between 2 groups（P=1.000）.At 2 weeks after operation,the patients had no headaches,infections,or other complications in2 groups.In patients with cervical dislocation,4 of the trial group and 6 of the control group failed to be reset,the reduction rate was 83.33%（20/24） and 68.42%（13/19） respectively,showing no significant difference（χ^2=0.618,P=0.432）.Conclusion The operation with modified traction arch of skull has significant advantages to reduce postoperative complication compared with tradition traction arch of skull.

关 键 词：颅骨牵引术 改良颅骨牵引弓 牵引弓滑脱 

分 类 号：R687.3[医药卫生—骨科学]