后路伤椎置钉短节段椎弓根螺钉内固定术对胸腰段椎体骨折患者围手术期应激指标、疼痛程度的影响  

Effects of posterior injured vertebra short-segment pedicle instrumentation on perioperative stress indicators and pain intensity in patients with thoracolumbar vertebral fracture

作　　者：薛龙海 XUE Longhai(Orthopedic Surgery Department,Xuchang Beihai Hospital,Xuchang 461100,China)

机构地区：[1]许昌北海医院骨外科,河南许昌461100

出　　处：《临床医学研究与实践》2024年第6期75-78,共4页Clinical Research and Practice

摘　　要：目的探究后路伤椎置钉短节段椎弓根螺钉内固定术(SSPI)治疗胸腰段椎体骨折(TVF)患者的效果。方法选取2021年12月至2022年11月我院收治的56例TVF患者为研究对象,按随机数字表法将其分为A组(n=28,后路伤椎置钉SSPI治疗)、B组(n=28,跨伤椎SSPI治疗)。比较两组的治疗效果。结果A组的手术耗时长于B组,卧床时长短于B组,术后引流量、术中失血量多于B组(P<0.05)。术后3个月,A组的伤椎前缘高度比(AVHR)大于B组,Cobb角小于B组(P<0.05)。术后1、3个月,两组的Oswestry功能障碍指数(ODI)、视觉模拟评分法(VAS)评分均低于术前,且A组低于B组(P<0.05)。术后1、3 d,两组的去甲肾上腺素(NE)、肌酸激酶(CK)、皮质醇(Cor)水平均高于术前,且A组高于B组(P<0.05)。两组的并发症总发生率无显著差异(P>0.05)。结论与跨伤椎SSPI相比,后路伤椎置钉SSPI治疗TVF患者可进一步减轻疼痛、提高腰椎功能、缩短卧床时长,但会略微增加术中失血量、术后引流量及手术创伤,延长手术耗时。Objective To explore the effect of posterior injured vertebra short-segment pedicle instrumentation(SSPI)in the treatment of patients with thoracolumbar vertebral fracture(TVF).Methods Fifty-six patients with TVF admitted in our hospital from December 2021 to November 2022 were selected as the study objects and divided into group A(n=28,posterior injured vertebra SSPI treatment)and group B(n=28,cross-injured vertebra SSPI treatment)according to random number table method.The therapeutic effects of the two groups were compared.Results The operation time of the group A was longer than that of the group B,the length of bed rest was shorter than that of the group B,and the postoperative drainage volume and intraoperative blood loss were more than those of the group B(P<0.05).At 3 month after surgery,the anterior vertebral height ratio(AVHR)of the group A was greater than that of the group B,and the Cobb angle was lower than that of the group B(P<0.05).At 1 and 3 month after surgery,Oswestry Disability Index(ODI)and Visual Analogue Scales(VAS)scores in both groups were lower than those before surgery,and those in the group A were lower than the group B(P<0.05).At 1 and 3 d after surgery,the levels of norepin ephrine(NE),creatine kinase(CK)and cortisol(Cor)in both groups were higher than those before surgery,and those in the group A were higher than the group B(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Compared with cross-injured vertebrae SSPI,posterior injured vertebrae SSPI in the treatment of TVF patients can further reduce pain,improve lumbar function and shorten length of bed rest,but it can slightly increase intraoperative blood loss,postoperative drainage flow and surgical trauma,and prolong the operation time.

关 键 词：后路伤椎 短节段椎弓根螺钉内固定术 胸腰段椎体骨折 应激指标 

分 类 号：R687.3[医药卫生—骨科学]