差异性椎弓根螺钉置入方式治疗胸腰段骨折的效果比较  

Comparison of the effects of different pedicle screw placement in patients with thoracolumbar fracture

作　　者：苟之琪 王利民[1] 赵亮[1] 王玉强[1] 张杨[1] Gou Zhiqi;Wang Limin;Zhao Liang;Wang Yuqiang;Zhang Yang(Department of Orthopedics,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州450000

出　　处：《河南医学研究》2018年第13期2323-2326,共4页Henan Medical Research

摘　　要：目的对比差异性椎弓根螺钉置入方式治疗胸腰段骨折的效果。方法选取2015年3月至2016年9月郑州大学第一附属医院收治的84例胸腰段骨折患者,按随机数表法分为研究组与对照组,各42例。两组患者均接受椎弓根钉棒复位内固定治疗,对照组接受传统后正中入路,研究组接受椎旁肌间隙入路。比较两组各项手术指标水平,手术前后视觉模拟评分法(VAS)评分、生命质量(QOL)评分,手术前后血清、5-羟色胺(5-HT)和P物质(SP)以及磷酸肌酸激酶水平。结果研究组手术时间、术中出血量、术后引流量以及住院时间分别为(75.69±13.25)min、(87.27±11.37)ml、(23.89±10.26)ml、(2.72±0.55)d,低于对照组的(124.11±24.79)min、(204.52±47.28)ml、(123.59±44.62)ml、(8.14±3.63)d(P<0.05)。术后研究组VAS评分为(3.25±0.47)分,低于对照组的(4.67±0.51)分,QOL评分为(41.37±5.47)分,高于对照组的(33.49±5.02)分(P<0.05)。术后研究组血清5-HT以及SP分别为(202.58±66.28)nmol/L、(34.36±17.62)pg/ml,低于对照组的(285.49±80.16)nmol/L、(42.74±20.29)pg/ml(P<0.05)。术后1、3 d研究组血清磷酸肌酸激酶水平分别为(402.38±42.37)、(174.67±31.65)U/ml,低于对照组的(624.31±76.29)、(378.59±40.93)U/ml(P<0.05)。结论椎旁肌间隙入路具有更好的安全性,可有效改善患者VAS、QOL评分,且有利于改善血清5-HT、SP以及磷酸肌酸激酶水平,值得临床推广应用。Objective To compare the effects of differential pedicle screw placement in patients with thoracolumbar fracture.Methods A total of 84 patients with thoracolumbar fracture from March 2015 to September 2016 in the First Affiliated Hospital of Zhengzhou University were randomly divided into study group and control group,and each had 42 cases. The patients of two groups were treated with screw fixation,and the control group was used by the traditional posterior median approach,the study group was treated by paraspinal muscle gap approach. The operation indexes,visual analogue scale（ VAS） score,quality of life（ QOL） score,serum 5-serotonin（ 5-HT）,substance P（ SP） and creatine kinase levels were compared in the two groups before and after surgery. Results In the study group,operation time,intraoperative bleeding,postoperative drainage,hospitalization time was（ 75. 69 ± 13. 25） min,（ 87. 27 ± 11. 37） ml,（ 23. 89 ± 10. 26） ml,（ 2. 72 ± 0. 55） d,which were significantly lower than the control group（ 124. 11 ± 24. 79） min,（ 204. 52 ± 47. 28） ml,（ 123. 59 ± 44. 62） ml,（ 8. 14 ± 3. 63） d（ P〈0. 05）. After operation,the VAS of the study group was（ 3. 25 ± 0. 47）,which was significantly lower than that of the control group（ 4. 67 ± 0. 51）,while the QOL score was（ 41. 37 ± 5. 47）,which was significantly higher than that of the control group（ 33. 49 ± 5. 02）（ P〈0. 05）. The serum 5-HT and SP in the study group were（ 202. 58 ± 66. 28） nmol/L,（ 34. 36 ±17. 62） pg/ml, which were significantly lower than that of the control group（ 285. 49 ± 80. 16） nmol/L,（ 42. 74 ±20. 29） pg/ml（ P〈0. 05）. The levels of serum creatine phosphokinase were（ 402. 38 ± 42. 37）,（ 174. 67 ± 31. 65） U/ml in the study group after 1 and 3 d,which were significantly lower than that of the control group（ 624. 31 ± 76. 29）,（ 378. 59 ±40. 93） U/ml（ P〈0. 05）. Conclusion Paraspinal muscle gap approach has better safety,and it ca

关 键 词：胸腰段骨折 椎弓根螺钉 椎旁肌间隙入路 

分 类 号：R683.2[医药卫生—骨科学]