山区县医院经椎旁肌间隙入路治疗胸腰椎骨折的应用  

The Application of Vertebral Side Clearance Treatment for Thoracolumbar Fractures in Mountainous Area

作　　者：罗庆明 黄福才 魏林平 陈振宇 钟巍巍 邹幼平 郑旭辉 袁权华 

机构地区：[1]广东省河源市龙川县人民医院,广东龙川517300

出　　处：《中国医学创新》2016年第13期129-133,共5页Medical Innovation of China

基　　金：2014年度河源市社会发展科技计划项目(2014-51)

摘　　要：目的:探讨在山区县医院行经椎旁肌间隙入路治疗胸腰椎骨折的可行性与临床疗效。方法:筛选2014年4月-2015年6月本院收治的胸腰椎骨折患者50例作为研究对象,根据患者手术入路方式将其分为观察组26例与对照组24例,其中观察组患者为经椎旁肌间隙入路进行手术固定,对照组为传统正中入路方案,比较两组患者手术用时、术中出血量、术后引流量、住院时间、术后腰部疼痛程度以及治疗总有效率等指标。结果:观察组患者手术用时、术中出血量、引流管留置时间、引流量、术后下地时间等指标均明显低于对照组,两组比较差异有统计学意义(P<0.05);两组患者术前1 d时VAS疼痛评分比较差异无统计学意义(P>0.05),但术后1 d、1个月VAS评分比较观察组明显优于对照组,两组比较差异均有统计学意义(P<0.05);固定拆除前两组患者JOA评分比较差异无统计学意义(P>0.05),但拆除固定3个月后观察组JOA评分明显高于对照组,即观察组患者疼痛程度明显低于对照组,两组比较差异有统计学意义(P<0.05),观察组患者治疗总有效率明显高于对照组,差异均有统计学意义(P<0.05);观察组患者Cobb角纠正率与对照组比较差异无统计学意义(P>0.05)。结论:采用经椎旁肌间隙入路治疗胸腰椎骨折疗效确切,较传统正中入路具有更低的医源性创伤,患者术后疼痛程度较低且恢复速度较快,并且可完全在基层山区县医院开展,具有临床应用及推广价值。Objective：To discuss the feasibility and clinical efficacy of vertebral side clearance treatment for thoracolumbar fractures in mountainous area hospital.Method：Fifty cases patients with thoracolumbar fractures admitted to our hospital from April 2014 to June 2015 were selected as the research objects,they were divided into the observation group of 26 cases and the control group of 24 cases according to the different surgical procedures.The observation group was given fixed vertebral side clearance surgery and control group was given the traditional approach.The indicators such as operation time,intraoperative blood loss,and postoperative drainage,length of hospital stays,postoperative lumbar pain degree and total effective treatment of the two groups were compared.Result：The operation time,intraoperative blood loss,drainage time,drainage volume and postoperative ambulation time of the observation group were significantly lower than the control group,the differences were statistically significant（P〈0.05）.The VAS pain score 1 d preoperatively of the two groups had no significant difference,while the VAS score of 1 d and 1 month postoperatively in the observation group were significant better than the control group,the difference were statistically significant（P〈0.05）.Before the internal fixation was dismantled,the JOA score of two groups was no significant difference,while the JOA score of the observation group 3 months after the remove of the internal fixation was obviously higher than that of the control group,which refered that the pain degree of observation group was obviously lower than the control group,and the total effective rate of the observation group was obviously higher than that of the control group,the differences were statistically significant（P〈0.05）.The Cobb angle correction rate in the observation group had no statistic significant difference compared with the control group（P〉0.05）.Conclusion：The vertebral side clearance treatment for thoracolumbar fractures has d

关 键 词：山区县基层医院 经椎旁肌间隙入路 胸腰椎骨折 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]