后路经皮微创椎弓根螺钉内固定术对脊柱骨折患者围术期指标、创伤应激指标及并发症的影响  

The effect of posterior minimally invasive percutaneous pedicle screw fixation on perioperative indexes,traumatic stress indexes and complications in patients with spinal fractures

作　　者：刘俊[1] 陈星[1] 梁佳佳[1] 池雨晨 LIU Jun;CHEN Xing;LIANG Jia-jia;CHI Yu-chen(Sichuan Orthopedic Hospital,Chengdu 610072,China)

机构地区：[1]四川省骨科医院,四川成都610072

出　　处：《实用医院临床杂志》2021年第3期139-142,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察后路经皮微创椎弓根螺钉内固定术治疗脊柱骨折对患者围术期指标、创伤应激指标及并发症的影响。方法选取我院85例脊柱骨折患者,均实施椎弓根螺钉内固定术,45例选择后路经皮微创法(A组),40例选择传统开放入路(B组),比较两组围术期指标、视觉模拟疼痛(VAS)评分、创伤应激指标[血清皮质醇(Cor)、C反应蛋白(CRP)、促肾上腺皮质激素(ACTH)、肿瘤坏死因子α(TNF-α)]、并发症情况。结果A组手术切口长度、术中出血量小于B组;手术时间、术后卧床时间与住院时间短于B组;术后1周VAS评分低于B组;术后1 d血清Cor、CRP、ACTH、TNF-α水平低于B组;并发症总发生率低于B组(P<0.05)。结论后路经皮微创椎弓根螺钉内固定术具有创伤小、手术时间短、术后恢复快的优点,能减轻脊柱骨折患者创伤应激反应与术后疼痛,降低并发症风险。Objective To observe the effect of posterior minimally invasive percutaneous pedicle screw fixation on perioperative indexes,traumatic stress indexes and complications in patients with spinal fractures.Methods Eighty-five patients with spinal fractures treated by pedicle screw fixation were selected.They were divided into group A(n=45)treated with posterior minimally invasive percutaneous approach and group B(n=40)treated with traditional open approach.Perioperative indexes,pain visual analogue scale(VAS)score,traumatic stress indexes such as serum cortisol(Cor),C-reactive protein(CRP),adrenocorticotropic hormone(ACTH)and tumor necrosis factor alpha(TNF-α)and complications were compared between the two groups.Results The incision length,intraoperative blood loss,operation time,postoperative time in bed and hospital stay of the group A were significantly shorter and less than those of the group B.The group A had significantly lower VAS score than the group B after 1 week of surgery.Level of Cor,CRP,ACTH and TNF-αin the group A after1 day of surgery were significantly lower than those in the group B.The total incidence of complications in the group A was significantly lower than that in the group B(P<0.05).Conclusion Posterior minimally invasive percutaneous pedicle screw fixation has the advantages of less trauma,shorter durationand faster postoperative recovery.It can reduce patients′traumatic stress response and postoperative pain and reduce the risk of complications.

关 键 词：后路经皮微创 椎弓根螺钉内固定术 围术期指标 创伤应激 

分 类 号：R683.2[医药卫生—骨科学]