经皮入路与经肌间隙椎弓根钉治疗胸腰椎骨折的临床疗效分析  

Clinical Effect of Percutaneous Approach and Transmuscular Pedicle Nail in the Treatment of Thoracolumbar Fracture

作　　者：高启龙 谭莹 全俊松 张欣铭[1] 陈建琨[1] Gao Qi-long;Tan Ying;Quan Jun-song;Zhang Xin-ming;Chen Jian-kun(Kunming Hospital of Traditional Chinese Medicine1,Kunming 650011,Yunnan Province,China;Yunnan Institute of Pharmaceutical Sciences2,Kunming 650011,Yunnan Province,China)

机构地区：[1]昆明市中医医院,云南昆明650011 [2]云南省药物研究所,云南昆明650011

出　　处：《中外医药研究》2023年第4期25-27,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:比较经皮入路与经肌间隙椎弓根钉治疗胸腰椎骨折的临床疗效。方法:回顾性分析2016年6月—2020年3月昆明市中医医院收治的采用椎弓根钉治疗的96例患者胸腰椎骨折的临床资料,根据入路方式不同分为经皮组(52例)与经肌间隙组(44例)。经肌间隙组选用经肌间隙椎弓根钉棒系统固定治疗,经皮组选用经皮椎弓根钉棒系统固定治疗。比较两组手术指标、疼痛视觉模拟量表(VAS)评分及治疗优良率。结果:经皮组术中出血量少于经肌间隙组,住院费用高于经肌间隙组,差异有统计学意义(P<0.001);术后1周、1个月,两组患者VAS评分均降低,同时间点经皮组VAS评分低于经肌间隙组,差异有统计学意义(P<0.001);两组患者治疗优良率比较,差异无统计学意义(P>0.05)。结论:经皮入路及经肌间隙治疗无神经损伤的胸腰椎骨折,疗效相当,不考虑经济的情况下,首选经皮椎弓根钉棒系统固定治疗。Objective:To compare the clinical effect of percutaneous approach and transmuscular pedicle nail in the treatment of thoracolumbar fracture.Methods:The clinical data of ninety-six patients with thoracolumbar and lumbar fractures treated with pedicle screws from June 2016 to March 2020 in Kunming Hospital of Traditional Chinese Medicine were retrospectively analyzed,and they were divided into percutaneous group(52 cases)and transmuscular space group(44 cases)according to different approach methods.Transmuscular pedicle nail screw fixation system was used in the transmuscular space group,and percutaneous pedicle screw fixation system was used in the percutaneous group.The surgical indexes,visual analogue scale(VAS)score and the rate of excellent and good treatment were compared between the two groups.Results:The intraoperative blood loss in the percutaneous group was less than that in the transmuscular space group,and the hospitalization cost was higher than that in the transmuscular space group,the difference was statistically significant(P<0.001).At 1 week and 1 month after surgery,the VAS score of both groups was decreased,and the VAS score of percutaneous group was lower than that of transmuscular space group at the same time point,with statistical significance(P<0.001).There was no significant difference in the rate of excellent treatment between the two groups(P>0.05).Conclusion:The treatment of thoracolumbar fractures without nerve damage by percutaneous approach and transmuscular space is equally effective,and percutaneous pedicle screw system fixation is preferred regardless of economic conditions.

关 键 词：经皮入路 经肌间隙入路 椎弓根钉 胸腰椎骨折 

分 类 号：R68[医药卫生—骨科学]