椎旁肌间隙入路与后正中入路用于胸腰椎骨折手术治疗的临床疗效分析  

Clinical Efficacy of Paraspinal Muscle Gap Approach and Posterior Median Approach in Treatment of Thoracolumbar Fractures

作　　者：罗奋棋[1] 林院[1] 徐杰[1] LUO Fenqi;LIN Yuan;XU Jie(ovincial Clinical College of Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床学院(福建省立医院),福建福州350001

出　　处：《中国医学创新》2017年第35期41-44,共4页Medical Innovation of China

摘　　要：目的:对椎旁肌间隙入路与后正中入路用于胸腰椎骨折手术治疗的临床疗效进行分析与探讨。方法:选取2015年3月-2017年3月本院收治的胸腰椎骨折患者100例,按照随机数字表法将其分为对照组和观察组,各50例。两组均接受手术治疗,观察组采用椎旁肌间隙入路,对照组采用后正中入路,比较两组手术时间、术中出血量、术后引流量、术前与术后1周椎体前缘高度、术前与术后1周、3个月、6个月的VAS评分及术后1周Cobb角纠正率。结果:观察组手术时间、术中出血量、术后引流量、术后1周椎体前缘高度及术后3个月、6个月VAS评分分别为(69.54±1.26)min、(59.26±20.58)m L、(25.49±1.07)m L、(92.45±0.21)mm、(1.15±0.56)分、(1.01±0.18)分,均显著优于对照组的(99.58±2.13)min、(187.05±52.56)m L、(245.13±62.81)m L、(91.56±0.16)mm、(1.76±2.05)分、(1.39±1.15)分,比较差异均有统计学意义(P<0.05)。结论:在胸腰椎骨折患者的手术过程中,采用经椎旁肌间隙入路治疗方式具有创伤小、出血少及术后疼痛少等优点,能够有效促进患者康复,短期疗效显著。Objective:To analyze and discuss the clinical effect of paraspinal muscle gap approach and posterior median approach in treatment of thoracolumbar fractures.Method:A total of 100 patients with thoracolumbar fractures in our hospital from March 2015 to March 2017 were selected,according to the random number table method,they were divided into control group and observation group,50 cases in each group.They were treated with surgical treatment,observation group adopted paraspinal muscle gap approach,and control group adopted posterior median approach.The operative time,intraoperative bleeding volume,postoperative drainage,height of anterior margin of vertebral body before and after operation 1 week,VAS score before and after operation 1 week,3 months,6 months,Cobb angle correction rate after operation 1 week were compared between two groups.Result:The operative time,intraoperative bleeding volume,postoperative drainage,height of anterior margin of vertebral body after operation 1 week,VAS score after operation 3 months,6 months of observation group were(69.54±1.26)min,(59.26±20.58)mL,(25.49±1.07)mL,(92.45±0.21)mm,(1.15±0.56)points,(1.01±0.18)points respectively,and control group were(99.58±2.13)min,(187.05±52.56)mL,(245.13±62.81)mL,(91.56±0.16)mm,(1.76±2.05)points,(1.39±1.15)points respectively,the differences were statistically significant(P<0.05).Conclusion:In operation process of thoracolumbar fracture,the use of paraspinal muscle gap approach has advantages of less trauma,less bleeding and less postoperative pain,can effectively promote the recovery of the patients,and the short-term effect is remarkable.

关 键 词：椎旁肌间隙 胸腰椎 骨折 临床价值 

分 类 号：R687.3[医药卫生—骨科学]