不同入路切开复位内固定术对胸腰椎压缩骨折患者应激反应及疼痛程度的影响  

Effect of Different Approaches of Open Reduction and Internal Fixation on Stress Response and Pain Degree in Patients with Thoracolumbar Compression Fracture

作　　者：彭亮 李城华 戴慧 刘玲玲 PENG Liang;LI Chenghua;DAI Hui;LIU Lingling(Leping Hospital of Traditional Chinese Medicine,Jiangxi Province,Leping 333300,China;不详)

机构地区：[1]江西省乐平市中医医院,江西乐平333300

出　　处：《中国医学创新》2023年第25期60-63,共4页Medical Innovation of China

摘　　要：目的:探讨不同入路切开复位内固定术对胸腰椎压缩骨折(TCF)患者应激反应及疼痛程度的影响。方法:选取乐平市中医医院2021年1月—2022年2月收治的79例TCF患者,依据随机数字表法分为对照组(n=40)、研究组(n=39)。两组均行切开复位内固定术,对照组经后正中入路,研究组经椎旁肌间隙入路。对比两组围手术期指标、应激反应指标[血清皮质醇(Cor)、前列腺素E_(2)(PGE_(2))]、术后疼痛程度[视觉模拟评分法(VAS)]、腰椎功能[Oswestry功能障碍指数(ODI)]及并发症发生情况。结果:研究组术中出血量、术后引流量均较对照组少,总住院时间较对照组短,差异均有统计学意义(P<0.05);研究组术后1 d Cor、PGE_(2)水平均较对照组低,差异均有统计学意义(P<0.05);研究组术后3、7 d VAS评分均较对照组低,术后6个月ODI评分较对照组低,差异均有统计学意义(P<0.05);两组并发症发生率对比,差异无统计学意义(P>0.05)。结论:相比后正中入路,TCF患者行经椎旁肌间隙入路切开复位内固定术可减少术中出血量与术后引流量,减轻机体应激反应,降低术后疼痛程度,利于腰椎功能恢复,且并发症少。Objective:To investigate the effect of different approaches of open reduction and internal fixation on stress response and pain degree in patients with thoracolumbar compression fracture(TCF).Method:A total of 79 TCF patients admitted to Leping Hospital of Traditional Chinese Medicine from January 2021 to February 2022 were selected and divided into control group(n=40)and study group(n=39)according to random number table method.Both groups were treated with open reduction and internal fixation,the control group was treated by posterior median approach,and the study group was treated by paravertebral muscle space approach.Perioperative indexes,stress response indexes[serum cortisol(Cor),prostaglandin E_(2)(PGE_(2))],postoperative pain degree[visual analogue scale(VAS)],lumbar function[Oswestry disability index(ODI)]and complications were compared between the two groups.Result:The intraoperative bleeding volume and postoperative drainage volume of the study group were lower than those of the control group,and the total hospital stay of the study group was shorter than that of the control group,the differences were statistically significant(P<0.05).1 d after operation,the levels of Cor and PGE_(2) in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The VAS scores of the study group at 3 and 7 d after operation were lower than those of the control group,and the ODI score at 6 months after operation was lower than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complica tions between the two groups(P>0.05).Conclusion:Compared with the posterior median approach,open reduction and internal fixation via the paravertebral muscle space approach in TCF patients can reduce intraoperative bleeding volume and postoperative drainage volume,alleviate the body's stress response,reduce the degree of postoperative pain,and facilitate the recovery of lumbar function with fewer comp

关 键 词：胸腰椎压缩骨折 切开复位内固定术 后正中入路 椎旁肌间隙入路 疼痛程度 

分 类 号：R687.3[医药卫生—骨科学]