后外侧减压植骨融合内固定治疗胸腰段爆裂骨折及术后切口感染原因探讨  

Investigation of posterolateral decompression bone grafting fusion internal fixation in the treatment of thoracolumbar burst fractures and causes of incision infection

作　　者：陈坤峰[1] 徐继胜[1] 赵志坚[1] 

机构地区：[1]河南省商丘市第一人民医院骨科,476000

出　　处：《中国实用医药》2016年第9期7-9,共3页China Practical Medicine

摘　　要：目的探讨后外侧减压植骨融合内固定治疗胸腰段爆裂骨折的效果及术后切口感染原因。方法 79例胸腰段爆裂骨折患者,对其采取后外侧减压植骨融合内固定治疗,对比患者手术前后的下肢运动功能以及生活质量的变化,同时检测椎体平均高度、椎体前缘高度、椎体后缘高度以及柱后突Cobb角变化,并评估术后切口感染的原因。结果治疗前,下肢运动功能评分和生活质量评分分别为(40.87±4.25)分和(49.75±4.61)分,显著低于治疗后的(74.12±4.25)分和(90.07±2.42)分,治疗前后比较差异均有统计学意义(P<0.01);同时,治疗后的椎体平均高度、椎体前缘高度、椎体后缘高度分别为(24.18±2.03)mm、(24.79±1.93)mm、(23.57±1.26)mm,明显高于治疗前的(18.41±1.09)mm、(18.22±1.67)mm、(19.46±1.15)mm,而治疗后的柱后突Cobb角为(9.13±1.83)°,低于治疗前的(27.83±3.44)°,治疗前后比较差异均有统计学意义(P<0.05);年龄、手术时间、术前合并症为术后切口感染高危因素。结论后外侧减压植骨融合内固定治疗胸腰段爆裂骨折的效果确切,其切口感染与患者年龄、手术时间、术前合并症等因素相关。Objective To investigate effect by posterolateral decompression bone grafting fusion internal fixation in the treatment of thoracolumbar burst fractures and causes of incision infection. Methods A total of 79 thoracolumbar burst fractures patients received posterolateral decompression bone grafting fusion internal fixation. Comparisons were made on lower limbs motor function and quality of life changes before and after operation, and detection was made on average vertebral height, vertebral anterior height, vertebral posterior height, and post column Cobb angle changes. Causes of postoperative incision infection were evaluated. Results Before treatment, patients had much lower scores in lower limbs motor function and quality of life as（40.87±4.25） and（49.75±4.61） points than（74.12±4.25） and（90.07±2.42） points after treatment. The differences had statistical significance before and after treatment（P〈0.01）. Meanwhile, they had all higher average vertebral height, vertebral anterior height, and vertebral posterior height as（24.18±2.03）,（24.79±1.93）, and（23.57±1.26） mm after treatment than（18.41±1.09）,（18.22±1.67）, and（19.46±1.15） mm before treatment. They had obviously lower post column Cobb angle after treatment as（9.13±1.83）° than（27.83±3.44）° before treatment. Their differences had statistical significance before and after treatment（P〈0.05）. High risk factors for postoperative incision infection included age, operation time, and preoperative complications. Conclusion Posterolateral decompression bone grafting fusion internal fixation provides precise effect in treating thoracolumbar burst fractures, and the incision infection is related with age, operation time, and preoperative complications.

关 键 词：后外侧减压植骨融合内固定术 胸腰段爆裂骨折 切口感染 原因 

分 类 号：R687.3[医药卫生—骨科学]