后路经肌间隙入路在治疗胸腰椎骨折脱位的效果探析  

Analysis of the Effect of Posterior Transmuscular Approach in the Treatment of Thoracolumbar Fracture and Dislocation

作　　者：安成功 李任重 段连永 AN Chenggong;LI Renzhong;DUAN Lianyong(Department of Orthopedics,People's Hospital of Dingtao District,Heze,Shandong Province,274100 China)

机构地区：[1]山东省菏泽市定陶区人民医院骨科,山东菏泽274100

出　　处：《世界复合医学》2021年第4期100-102,182,共4页World Journal of Complex Medicine

摘　　要：目的探讨后路经肌间隙入路治疗胸腰椎骨折脱位的应用效果。方法选取该院2018年4月—2019年4月84例胸腰椎骨折脱位患者,按照不同手术治疗方式分为两组。对照组42例采用传统后正中入路治疗,观察组42例患者采用后路经肌间隙入路治疗,对两组患者手术治疗指标、视觉模拟疼痛评分(VAS)、肌酸磷酸激酶(CK)进行分析。结果观察组手术时间(53.28±3.15)min、术中出血量(100.05±20.74)mL、术后引流量(21.48±2.94)mL、住院时间(6.05±1.43)d,均显著优于对照组的(67.59±4.02)min、(312.85±21.43)mL、(98.72±11.23)mL、(8.64±2.09)d,差异有统计学意义(t=18.159、46.243、43.121、6.628,P<0.05);治疗前,观察组VAS(5.71±1.26)分、CK值(117.98±12.34)IU/L与对照组(5.59±1.30)分、(120.45±12.08)IU/L,差异无统计学意义(t=0.430、0.927,P=0.669、0.357);手术后1、3、7 d观察组VAS评分依次为(3.54±0.35)分、(2.01±0.64)分、(0.87±0.12)分,均显著低于对照组的(4.89±0.97)分、(2.74±0.38)分、(1.69±0.44)分,差异有统计学意义(t=8.484、6.356、11.652,P<0.05),手术后1、3 d,观察组CK分别为(576.68±23.42)、(412.37±26.68)IU/L,显著低于对照组(860.09±50.67)、(549.32±30.05)IU/L,差异有统计学意义(t=32.904、22.086,P<0.05)。结论采用后路经肌间隙入路在治疗胸腰椎骨折脱位,可提高手术治疗效率,减轻椎旁肌损伤。Objective To explore the effect of posterior transmuscular approach in the treatment of thoracolumbar fracture and dislocation.Methods A total of 84 patients with thoracolumbar fracture and dislocation in the hospital from April 2018 to April 2019 were selected and divided them into two groups according to different surgical treatment methods.42 patients in the control group were treated with traditional posterior median approach,and 42 patients in the observation group were treated with posterior transmuscular approach.The surgical treatment indicators,visual analog pain score(VAS),and creatine phosphokinase(CK)were analyzed in the two groups.Results The operation time(53.28±3.15)min,intraoperative blood loss(100.05±20.74)mL,postoperative drainage volume(21.48±2.94)mL,and hospital stay(6.05±1.43)d in the observation group were significantly better than those in the control group(67.59±4.02)min,(312.85±21.43)mL,(98.72±11.23)mL,(8.64±2.09)d,and the difference was statistically significant(t=18.159,46.243,43.121,6.628,P<0.05);before treatment,there was no significant difference in VAS(5.71±1.26)points and CK(117.98±12.34)IU/L in the observation group and(5.59±1.30)points and(120.45±12.08)IU/L in the control group(t=0.430,0.927,P=0.699,0.357);1 d,3 d,and 7 d after surgery,the VAS scores of the observation group were(3.54±0.35)points,(2.01±0.64)points,(0.87±0.12)points,all significantly lower than(4.89±0.97)points,(2.74±0.38)points,(1.69±0.44)points of the control group,and the difference was statistically significant(t=8.484,6.356,11.652,P<0.05),observation group 1 d and 3 d after surgery of the CK were(576.68±23.42)IU/L,(412.37±26.68)IU/L,which was significantly lower than the control group’s(860.09±50.67)IU/L,(549.32±30.05)IU/L,the difference was statistically significant(t=32.904、22.086,P<0.05).Conclusion The use of posterior transmuscular approach in the treatment of thoracolumbar fractures and dislocations can improve the efficiency of surgical treatment and reduce paraspinal muscle in

关 键 词：胸腰椎骨折脱位 后路经肌间隙入路 手术指标 疼痛程度 

分 类 号：R68[医药卫生—骨科学]