后路经椎旁肌间隙入路椎弓根螺钉内固定对腰椎骨折患者关节与功能恢复及血清磷酸肌酸激酶水平的影响  

Effects of screw internal fixation in pedicle of vertebral arch via posterior paravertebral muscle gap approach on joint and functional recovery and serum creatine phosphokinase levels in the patients with lumbar fractures

作　　者：汤雄飞 钱越宁 顾宣歆 孙彦[1] 阮朝阳[1] 

机构地区：[1]浙江省海宁市人民医院骨科,浙江海宁314400

出　　处：《中国现代医生》2017年第13期71-74,共4页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(B类)(2015KYB395)

摘　　要：目的分析后路经椎旁肌间隙入路椎弓根螺钉内固定对腰椎骨折患者关节与功能恢复及血清磷酸肌酸激酶水平的影响。方法选取我院从2014年7月~2016年9月收治的110例腰椎骨折患者病患为研究对象,抽签法随机分为两组,对照组进行椎弓根入螺钉内治疗,实验组经后路颈椎旁间隙入路椎弓根螺钉内固定治疗,比较两组的关节恢复功能与血清磷酸肌酸激酶水平等。结果对照组患者术中出血量为(322.6±22.8)m L、术后引流量为(108.6±18.4)m L,矫正率为(82.6±4.4)%,椎弓根钉植入为(98.6±4.2)%,手术时间为(154.8±13.5)min,实验组患者术中出血量为(173.5±19.3)m L,术后引流量为(68.9±12.4)m L,矫正率为(83.2±4.3)%,椎弓根钉植入为(98.8±3.6)%,手术时间为(129.4±16.3)min,实验组术中出血量、术后引流量、手术时间低于对照组,具有差异性(P<0.05);实验组在术前VAS分数为(7.6±1.0)分,术后两周为(3.2±0.9)分,术后1个月为(1.5±0.4)分,术后6个月为(0.6±0.3)分,对照组在术前VAS分数为(7.5±1.0)分,术后两周为(4.5±1.2)分,术后1个月为(3.9±0.8)分,术后6个月为(2.8±0.6)分,具有差异性(P<0.05),实验组手术前,实验组血清磷酸肌酸激酶活性[(65.92±4.54)U/m L],手术后为[(54.92±3.89)U/m L],对照组为血清磷酸肌酸激酶活性[(64.34±2.54)U/m L],手术后为[(42.56±3.28)U/m L],实验组高于对照组,具有差异性(P<0.05)。结论腰椎骨折患者实施手法复位联合后路经椎旁肌间隙入路椎弓根螺钉内固定治疗提高疗效,缩短患者手术时间和住院时间,减轻患者疼痛,改善血清磷酸肌酸激酶活性,具有临床应用价值。Objective To analyze the effect of screw internal fixation in pedicle of vertebral arch via posterior paraver- tebral muscle gap approach on joint and functional recovery and serum creatine phosphokinase levels in the patients with lumbar fractures. Methods 110 patients with lumbar fractures in our hospital from January 2014 to September 2016 were selected as the study subjects. They were randomly divided into two groups according to the drawing lot method. The control group was given screw internal fixation in pedicle of vertebral arch, and the experimental group was given screw internal fixation in pedicle of vertebral arch via posterior paravertebral muscle gap approach. The joint recovery function and serum creatine phosphokinase levels were compared between the two groups. Results In the control group, the intraoperative blood loss was（322.6±22.8）mL, the postoperative drainage was（ 108.6±18.4）mL, the correction rate was（82.6±4.4）%, the pedicle screw implantation was（98.6±4.2）%, and the operation time was（154.8±13.5,）min. In the experimental group, the intraoperative blood loss was（ 173.5±19.3）mL, the postoperative drainage was（68.9± 12.4）mL, the correction rate was（83.2±4.3）%, the pedicle screw implantation was （98.8±3.6）%, and the operation time was（129.4±16.3）min. The intraoperative blood loss, postoperative drainage volume and operation time in the experimental group were lower than those in the control group, and the differences were significant（P〈0.05）; in the experimental group, the VAS score before the surgery was （7.6±1.0）, the score 2 weeks after the surgery was （3.2±0.9）, the score 1 month after the surgery was（1.5±0.4）, and the score 6 months after the surgery was（0.6±0.3）. In the control group, the VAS score before the surgery was （7.5±1.0）, the score 2 weeks after the surgery was （4.5±1.2）, the score 1 month after the surgery was（3.9±0.8）, and the score 6 months after the surgery was （2.8±0.6）. The di

关 键 词：后路经椎旁肌间隙 椎弓根螺钉内固定 腰椎骨 血清磷酸肌酸激酶 

分 类 号：R683.2[医药卫生—骨科学]