颈部横切口与斜切口对颈前路手术疗效的影响  

Comparison of the outcomes of cervical anterior procedure by transverse or oblique incision

作　　者：唐尚文 王弘 徐宏光 王凌挺 赵泉来 刘晨 TANG Shangwen;WANG Hong;XU Hongguang;WANG Lingting;ZHAO Quanlai;LIU Chen(Department of Spinal Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院脊柱外科,安徽芜湖241001

出　　处：《皖南医学院学报》2017年第6期528-531,共4页Journal of Wannan Medical College

基　　金：国家自然科学基金项目(81272048);安徽省教育厅自然科学研究基金重点项目(KJ2013A253)

摘　　要：目的:探讨颈前路横切口与斜切口对颈前路手术的手术时间、术中出血量、手术疗效及术后颈部皮肤瘢痕的影响。方法:对28例颈椎退行性疾病、颈椎外伤及其他需要行颈椎前路手术疾病的患者采用不同手术入路,其中采用颈前路横切口16例(A组)、颈前路斜切口12例(B组)。对两组患者减压节段、术中情况、手术疗效、术后颈部皮肤瘢痕愈合情况进行比较。结果:A、B两组患者术中减压节段的差异有统计学意义(P<0.05)。A、B两组患者均顺利完成手术,术后疗效良好。两组患者瘢痕情况差异有统计学意义(P<0.05)。A、B两组手术前后的JOA评分差异均有统计学意义(P<0.05)。两组患者JOA改善率差异无统计学意义(P>0.05)。结论:(1)颈前路手术横切口与斜切口均能获得良好的术后疗效;(2)颈前路手术斜切口可获得较佳的手术视野和操作空间,对于初学者及手术经验欠丰富的医师,可选择斜切口入路;(3)颈前路手术横切口可减少术后颈部皮肤瘢痕的形成,对于瘢痕体质患者或对术后皮肤愈合美观要求高的的患者,可选择横切口入路。Objective:To investigate the effects of anterior cervical procedure using transverse incision or oblique incision on the operative time,intraoperative blood loss,surgical outcomes and cervical skin scar following surgery.Methods:Twenty eight patients with cervical spondylotic myelopathy,cervical trauma or other cervical conditions were included.Cervical anterior procedures were performed by either transverse incision(n=16,group A)or oblique incision(n=12,group B).Then the two groups were compared regarding the outcomes of cervical decompression,intraoperative incidence,surgical efficacies,and skin scar after wound healing.Results:Surgery was successfully completed in the two group,and the cervical decompression,curative effect,skin scar after wound healing as well as scores by the criteria of the Japanese Orthopaedic Association(JOA)before and after operation were different between groups(all P<0.05),yet improvement rate by JOA was not significantly different between the two group(P>0.05).Conclusion:①Cervical anterior procedure by transverse or oblique incision can lead to better curative effect;②Oblique incision may be optional for surgeons in early practice or those with fewer experience because of this approach being cable to create better surgical field and operating space;③Transverse incision can be favorable to cosmetic results because it reduces the degree of scar formation following wound healing.

关 键 词：颈前路手术 切口方向 瘢痕 

分 类 号：R687.3[医药卫生—骨科学]