胸腰椎骨折切开复位内固定术在新型野战综合手术救治方舱中应用可行性研究  

The feasibility study of ORIF of thoracolumbar vertebral fracture in the field operation rescue shelter

作　　者：李卓[1] 于海龙[1] 谢雁春 张昊聪 赵阳阳[1] 张猛 韩雅玲[2] 

机构地区：[1]沈阳军区总医院骨科,辽宁沈阳110016 [2]沈阳军区总医院心内科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第2期172-174,共3页Clinical Journal of Medical Officers

基　　金：军事医学创新工程项目(16CXZ006)

摘　　要：目的探讨在战争或灾难救治现场,于新型野战综合手术救治方舱中对无神经症状的胸腰椎骨折患者行后路切开复位内固定的可行性。方法于沈阳军区总医院新型野战综合手术救治方舱中对15只实验猪行胸腰椎骨折切开复位内固定,统计分析实验猪的体质量、置钉数量、手术时间、术中失血量、术后四肢活动及术后感染情况。结果本组15只实验猪均在新型野战综合手术救治方舱中顺利完成手术,手术时间为53~69 min,平均手术时间为(61.25±3.15)min;术中失血量120~180 ml,平均失血量为(145.62±10.34)ml。本研究共置入90枚椎弓根螺钉,术后15只实验猪均可正常行走,步态与术前比较,未见明显差异。术后3 d,15只实验猪中2只出现发热症状。结论在新型野战手术救治方舱中对无神经症状的胸腰椎骨折行后路切开复位内固定术是一种较有效的方法,具有手术时间短、术中透视次数少、术后感染的发生率低等优点。Objective To discuss the feasibility of open reduction with internal fixation（ ORIF） of thoracolumbar vertebral fracture without neurological symptom in the new field comprehensive operation rescue shelter under the war or disaster treatment site.Methods Fifteen pigs with thoracolumbar vertebral fracture were rescued by ORIF in the new field comprehensive operation rescue shelter and the weight of pigs,the number of pedicle screws,the operation time,intra-operative bleeding,postoperative limbs activity and infection were statistically analyzed. Results All the operations performed on the 15 pigs in the field operation rescue shelter were successful. The operation time was 53-69 minutes,mean operation time was（ 61. 25 ± 3. 15） minutes; intra-operative bleeding was 120-180 ml,mean bleeding was（ 145. 62 ± 10. 34） ml. A total of 90 pedicle screws were placed,all 15 pigs can walk normally after operation,and the gait was not significantly different from that before the operation. There were 2 pigs had a fever in the 3 days after operation. Conclusion The ORIF treatment of thoracolumbar vertebral fracture in the field operation rescue shelter is an effective method,with the advantages of short operation time,less fluoroscopy and low incidence of postoperative infection.

关 键 词：野战方舱 胸腰椎骨折 切开复位内固定 

分 类 号：R687.3[医药卫生—骨科学]