过伸复位法联合可调式脊柱外固定器不同固定高度下对胸腰椎压缩骨折效果影响研究  

Effect Research of Overextension Reduction Combined with Adjustable External Fixator at Different Fixation Heights on Thoracolumbar Compression Fracture

作　　者：仲锋锋 孟祥奇[3] 朱宏[2] 农宁 欧炳金 程顺达 ZHONG Fengfeng;MENG Xiangqi;ZHU Hong;NONG Ning;OU Bingjin;CHENG Shunda(Yancheng Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 224001,Jiangsu,China;Nanjing University of Chinese Medicine,Nanjing 224000,Jiangsu,China;Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou 215000,Jiangsu,China)

机构地区：[1]南京中医药大学附属盐城中医院,江苏盐城224001 [2]南京中医药大学,江苏南京224000 [3]南京中医药大学附属苏州市中医医院,江苏苏州215000

出　　处：《辽宁中医药大学学报》2023年第8期197-203,共7页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：苏州市第五批姑苏卫生人才培养项目(GSWS2019021)。

摘　　要：目的观察过伸复位法联合可调式脊柱外固定器不同固定高度下对胸腰椎压缩骨折临床效果的影响。方法采用回顾性研究分析2016年6月—2021年12月就诊于苏州市中医医院骨伤科门急诊及住院符合纳入标准的胸腰椎压缩骨折52例病例资料,所有患者均采用手法复位+可调式脊柱外固定器,根据固定角度不同,分为10°组、15°组、20°组及25°组4组,每组13例,Cobbe角、数字等级评定量表(number rating scale,NRS)疼痛评分、舒适度评分、功能障碍评分(the Oswestry disability index,ODI),记录并比较各组复位前、复位后、复位后4周、复位后8周、复位后6个月的椎体前缘高度比(anterior vertebral height ratio,AVRA)、Cobbe角、NRS评分、自拟评分及末次ODI评分,探究外固定器不同固定角度对伤椎复位后高度维持效果及临床疗效的影响,以明确既能满足临床治疗效果又可以减少患者固定期间不适感的最佳固定角度。结果52例患者均获得随访,随访时间6~8个月,四组患者在性别、年龄、体质量、损伤原因、损伤节段及损伤至复位时间上对比差异无统计学意义(P>0.05)。四组AVRA、NRS评分、舒适度评分、Cobbe角在复位后、复位后第4周、第8周及第6月与复位前组内对比方面,差异均具有统计学意义(P<0.001),AVRA在复位前及复位后时间点上,四组之间对比差异无统计学意义(P>0.05),NRS评分及舒适度评分在复位前及复位后第6月时间点上,四组之间对比差异无统计学意义(P>0.05)。椎体前缘高度比方面:复位后的第4周、8周及6月在椎体前缘高度丢失上,10°组明显多于15°、20°及25°组(P<0.05),复位后的第8周及6月,15°组、20°组及25°组在AVRA上对比三者之间差异无统计学意义(P>0.05)。NRS评分方面:在复位后、第4周及第8周时间点上10°与15°组疼痛缓解明显优于20°与25°组(P<0.05)。舒适度评分方面:复位后、第4周及第8周10°与15°组舒�Objective To obsearve the effects of hyperextension reduction combined with adjustable spinal external fixator on the clinical effect of thoracolumbar compression fractures under different fixation heights.Methods A retrospective study was used to analyze the data of 52 cases of thoracolumbar compression fractures who met the inclusion criteria in the outpatient and emergency department of the department of orthopedics and traumatology of Suzhou hospital of traditional Chinese medicine from June 2016 to December 2021.All patients were treated with manual reduction+adjustable Spinal external fixators are divided into four groups:10°group,15°group,20°group,and 25°group according to different fixation angles,with 13 cases in each group.To record the four groups of Anterior vertebral height ratio(AVRA),Cobbe angle,NRS pain score,self-made score,ODI score,and compare the four groups before reduction,after reduction,4 weeks after reduction,and 8 weeks after reduction,6 months after reduction,the anterior edge height ratio,Cobbe angle,NRS score,self-developed score and last ODI score,to explore the effect of different fixation angles of external fixator on the height maintenance effect and clinical efficacy of injured vertebrae after reduction,in order to clarify the best fixation angle that can not only meet the clinical treatment effect but also reduce the discomfort of the patient during fixation.Results All 52 patients were followed up for 6 to 8 months.There was no significant difference in sex,age,body mass,cause of injury,segment of injury and time from injury to reduction among the four groups(P>0.05).There were significant differences in AVRA,NRS score,comfort score and Cobbe angle between the four groups before and after reduction,4 weeks,8 weeks and 6 months after reduction(P<0.001).There was no significant difference in AVRA before and after reduction among the four groups.NRS score and comfort score were at the time points before and 6 months after reduction.There was no significant difference among the

关 键 词：手法复位 外固定器 固定高度 胸腰椎压缩骨折 保守治疗 中医药 

分 类 号：R274.13[医药卫生—中医骨伤科学] R683[医药卫生—中医学]