经皮微创椎弓根螺钉内固定对Magerl A3型胸腰椎骨骨折患者术后恢复的影响分析  

EFFECTS OF MINIMALLY INVASIVE PERCUTANEOUS PEDICLE SCREW FIXATION ON POSTOPERATIVE RECOVERY OF PATIENTS WITH MAGERL A3 THORACOLUMBAR FRACTURE

作　　者：张杰 刘煊文 周强 陈丹 强喆 ZHANG Jie;LIU Xuanwen;ZHOU Qiang;CHEN Dan;QIANG Zhe(Chengdu 363 Hospital Affiliated to Southwest Medical University,Chengdu 610000,China)

机构地区：[1]西南医科大学附属成都三六三医院,610000

出　　处：《中国煤炭工业医学杂志》2022年第6期639-642,共4页Chinese Journal of Coal Industry Medicine

基　　金：四川省科技厅支撑课题项目(编号:05SC022-008)。

摘　　要：目的 分析经皮微创椎弓根螺钉内固定对Magerl A3型胸腰椎骨骨折患者术后恢复的影响。方法 选取2019年5月—2020年5月该院治疗的92例Magerl A3型胸腰椎骨骨折患者进行回顾性分析,根据手术方式将患者分为经皮组(n=45)和开放组(n=47),开放组行传统切开椎弓根螺钉内固定;经皮组行经皮微创椎弓根螺钉内固定。统计比较两组围术期手术记录、影像学指标、疼痛程度和炎症因子水平。结果 经皮组手术时间、术中出血量、首次下床活动时间和平均住院天数均明显少于开放组(P<0.05);两组患者术后椎体前缘高度明显增加(P<0.05),Cobb角明显减小(P<0.05),但组间比较差异无统计学意义(P>0.05);术后3d、1个月,经皮组患者视觉模拟评分(VAS)明显低于开放组(P<0.05);术后24h,经皮组患者CK、CRP水平明显低于开放组(P<0.05)。结论 经皮微创与传统切开椎弓根螺钉内固定对Magerl A3型胸腰椎骨骨折患者均有较好的治疗效果,但行经皮微创椎弓根螺钉内固定治疗的患者疼痛轻、出血少、血清炎症因子水平低,手术时间和住院时间短,值得临床推广应用。Objective To analyze the effect of minimally invasive percutaneous pedicle screw fixation on postoperative recovery of patients with Magerl A3 thoracolumbar fracture.Methods A retrospective analysis was performed on ninety-two patients with Magerl A3 thoracolumbal fracture treated in Chengdu 363 Hospital Affiliated to Southwest Medical University from May 2019 to May 2020.Patients were divided into percutaneous group(n=45) and open group(n=47) according to surgical methods.The open group received traditional open pedicle screw fixation.The percutaneous group received percutaneous minimally invasive pedicle screw fixation.Perioperative surgical records,imaging indicators,pain degree and inflammatory factor levels were statistically compared between the two groups.Results The operative time,intraoperative blood loss,first ambulation time and average length of hospital stay in percutaneous group were significantly less than those in open group(P0.05).The visual analog scale(VAS) score in percutaneous group was significantly lower than that in open group at 3 d and 1 month after surgery(P<0.05).24 h after surgery,the levels of CK and CRP in percutaneous group were significantly lower than those in open group(P<0.05).Conclusion Both minimally invasive percutaneous and traditional open pedicle screw fixation have good therapeutic effect on patients with Magerl A3 thoracolumbar fracture.However,patients treated with minimally invasive percutaneous pedicle screw fixation have less pain,less bleeding,lower serum inflammatory factors,and shorter operation time and hospital stay,which are worthy of clinical promotion and application.

关 键 词：经皮微创椎弓根螺钉内固定 传统切开椎弓根螺钉内固定 胸腰椎骨骨折 术后恢复 

分 类 号：R318[医药卫生—生物医学工程]