非椎板减压椎弓根螺钉撑开复位对腰椎爆裂性骨折患者创伤应激反应及术后腰椎功能恢复的影响  

Effect of non laminectomy and pedicle screw reduction on traumatic stress and lumbar functional recovery in patients with lumbar burst fractures

作　　者：王飞 WANG Fei(Department of Orthopaedic Surgery,Xinwen Central Hospital of Shandong Guoxin Yiyang group,Xintai,Shandong,271219,China)

机构地区：[1]山东国欣颐养集团新汶中心医院骨外科,山东新泰271219

出　　处：《当代医学》2023年第20期69-72,共4页Contemporary Medicine

摘　　要：目的探讨非椎板减压椎弓根螺钉撑开复位对腰椎爆裂性骨折患者机体创伤应激反应、术后腰椎功能恢复的影响。方法选取2018年6月至2021年6月于本院接受椎弓根螺钉撑开复位治疗的70例腰椎爆裂性骨折患者作为研究对象,采用随机数字表法分为两组,每组35例。对照组于椎弓根螺钉撑开复位前接受椎板减压,观察组不接受椎板减压,比较两组不同时间皮质醇(Cor)、促肾上腺皮质激素(ACTH)、人β-内啡肽水平和腰椎椎体参数(Cobb角、椎体高度比、椎管占位率)及疼痛评分。结果两组Cor、ACTH、β-内啡肽水平组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:术后1周,两组Cor水平均低于术后3d和术前,但术后3d均高于术前,差异有统计学意义(P<0.05);术后3d、1周,对照组ACTH、β-内啡肽水平均高于术前,而术后1周β-内啡肽水平低于术后3d,差异有统计学意义(P<0.05),术后3d与术后1周ACTH比较差异无统计学意义;术后3d,观察组ACTH、β-内啡肽水平均高于术前、术后1周,而术后1周与术前比较差异无统计学意义。组间比较:术前,两组Cor、ACTH、β-内啡肽水平比较差异无统计学意义;术后3d、术后1周,观察组Cor、ACTH、β-内啡肽水平均明显低于对照组,差异有统计学意义(P<0.05)。两组Cobb角、椎体高度比及椎管占位率时间比较差异有统计学意义(P<0.05),但组间、交互比较差异无统计学意义。组内比较:术后1周、6个月,两组椎体高度比均高于术前,Cobb角均小于术前,椎管占位率均低于术前(P<0.05),而术后1周与术后6个月Cobb角、椎体高度比和椎管占位率比较差异均无统计学意义。组间比较:两组不同时间Cobb角、椎体高度比及椎管占位率比较差异均无统计学意义。两组视觉模拟评分法(VAS)评分时间比较差异有统计学意义(P<0.05),但组间、交互比较差异无统计学意义。组内比较:术后1周、6个月,两�Objective To investigate the effect of non laminectomy and pedicle screw reduction on traumatic stress and lumbar functional recov-ery in patients with lumbar burst fractures.Methods 70 patients with lumbar burst fractures who underwent pedicle screw reduction treatment in our hospital from June 2018 to June 2021 were selected as the study subjects,they were divided into the two groups according to the random number ta-ble method,with 35 cases in each group.The control group received vertebral plate decompression before open reduction treatment,while the obser-vation group receive without vertebral plate decompression treatment.The levels of cortisol(Cor),adrenocorticotropic hormone(ACTH),humanβ-endorphins level,lumbar vertebral parameters(Cobb angle,vertebral height ratio,vertebral canal occupancy rate)and pain score were compared be-tween the two groups at different times.Results There were statistically significant differences in the levels of Cor,ACTH andβ-endorphin between the two groups of group,time points and interaction(P<0.05).Comparison within groups:1 week after operation,the levels of Cor of the two groups were lower than those at 3 d after operation and before operation,but the 3 d after operation were higher than those before operation,and the differences were statistically significant(P<0.05);at 3 d and 1 week after operation,the levels of ACTH and humanβ-endorphin in the control group were higher than those before operation,and the levels of humanβ-endorphin at 1 week after operation were lower than those at 3 d after oper-ation,the differences were statistically significant(P<0.05),but there was no statistically significant difference in the level of ACTH between 3 d and 1 week after operation;3 d after operation,the levels of ACTH and humanβ-endorphin in the observation group were higher than those before operation and 1 week after operation,but there was no significant difference between 1 week after operation and before operation.Comparison be-tween groups:before operation,there were no

关 键 词：椎弓根螺钉撑开复位 非椎板减压 腰椎爆裂性骨折 创伤应激 椎体功能 

分 类 号：R687.3[医药卫生—骨科学]