过伸复位法结合椎弓根钉内固定术与传统后路切开复位内固定术治疗胸腰椎爆裂性骨折的临床疗效分析  

Comparison of clinical efficacy between hyperextensive reduction combined with pedicle screw fixation and traditional posterior open reduction with internal fixation for thoracolumbar burst fractures

作　　者：赵鑫 ZHAO Xin(Department of Orthopedics,Nanchong Central Hospital,Nanchong 637000,China)

机构地区：[1]四川省南充市中心医院骨科,四川南充637000

出　　处：《实用医院临床杂志》2018年第6期104-107,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨过伸复位法结合椎弓根螺钉内固定术治疗胸腰椎爆裂性骨折(TLBF)的临床效果。方法回顾性分析124例TLBF患者临床资料,行过伸复位法结合椎弓根钉内固定术者纳入观察组(n=89),行传统切开复位内固定术治疗者纳入对照组(n=35)。比较术前及术后3个月、6个月时两组伤椎形态参数(矢状面后凸Cobb角、前缘高度比)、疼痛度[视觉模拟法疼痛评分标准(VAS)]、生活质量[世界卫生组织生存质量测定简表(WHOQOL-BREF)],分析两组围术期基本情况、术后6个月时中医证候疗效及6个月内并发症发生情况差异。结果术后3、6个月时,两组矢状面后凸Cobb角水平均较术前显著下降,前缘高度比水平均较术前显著提升,术后6个月时组间比较差异有统计学意义(P <0. 05);两组VAS评分均较术前显著下降,且观察组低于对照组;两组WHOQOL-BREF评分均较术前显著提升,且观察组高于对照组(P <0. 05)。观察组手术时间、术中出血量、术后引流量、自控镇痛泵按压频次、下床活动时间、住院时间均少于对照组(P <0. 05)。术后6个月,观察组中医证候疗效总有效率高于对照组,并发症总发生率低于对照组(P <0. 05)。结论过伸复位法结合椎弓根螺钉固定术治疗TLBF效果较传统后路切开复位内固定术更为显著,对患者临床症状改善及伤椎正常形态保持有利。To explore the clinical effects of hyperextensive reduction combined with pedicle screw fixation in the treatment of thoracolumbar burst fractures(TLBF).The clinical data of 124 TLBF patients were retrospectively analyzed.Those patients who underwent hyperextensive reduction combined with pedicle screw fixation were included in observation group(n=89),and those who were treated with traditional posterior open reduction with internal fixation were included in the control group(n=35).The morphological parameters of injured vertebrae such as sagittal kyphosis Cobb angle and anterior height ratio,pain degree[(visual analogue scale(VAS)],and quality of life[WHO Quality of Life-BREF(WHOQOL-BREF)]were compared before operation and after 3 and 6 months of operation.The perioperative basic conditions,efficacy of TCM syndromes after 6 months of operation and occurrence of complications within 6 months were analyzed in the two groups.After 3 and 6 months of operation,the sagittal kyphosis Cobb angle in the two groups was significantly lower while the anterior height ratio was significantly higher than that before operation(all P<0.05),and there was a statistically significant difference between the two groups after 6 months of operation(P<0.05).The VAS score in the two groups was significantly lower than that before operation,and the score in the observation group was significantly lower than that in the control group(all P<0.05).The WHOQOL-BREF score in the two groups was significantly higher than that before operation,and the score in observation group was significantly higher than that in the control group(all P<0.05).The operative time,intraoperative blood loss,postoperative drainage volume,frequency of self-controlled analgesia pump press,ambulation time and hospital stay were significantly shorter or less in the observation group than those in the control group(all P<0.05).After 6 months of operation,the total effective rate of efficacy of TCM syndromes in the observation group was significantly higher than that in th

关 键 词：过伸复位法 椎弓根螺钉 内固定 切开复位 胸腰椎爆裂性骨折 

分 类 号：R683.2[医药卫生—骨科学]