经伤椎单侧椎弓根螺钉内固定术对急性脊柱创伤患者远期康复的影响  

Effect of Unilateral Pedicle Screw Fixation on Immune Function and Long-term Functional Rehabilitation of Patients with Acute Spinal Trauma

作　　者：邓智斌 Deng Zhibin(Department of Orthopedics,Songgang People’s Hospital,Baoan District,Shenzhen,Shenzhen Guangdong 518000)

机构地区：[1]深圳市宝安区松岗人民医院骨科,广东深圳518000

出　　处：《黑龙江医药》2024年第5期1053-1056,共4页Heilongjiang Medicine journal

基　　金：深圳市宝安区社会公益项目(项目编号:2022JD185)。

摘　　要：目的:经伤椎单侧椎弓根螺钉内固定术对急性脊柱创伤患者免疫功能及远期功能康复的影响。方法:取2021年10月—2024年2月期间我院收治的80例急性脊柱创伤患者为研究对象,以随机数字表法分组,对照组采用传统双侧椎弓根螺钉内固定术,观察组行经伤椎单侧椎弓根螺钉内固定术,对两组患者手术效果、免疫功能、术后不良事件进行比较。结果:观察组(手术、卧床、住院)时间及术中出血量均较对照组低(P<0.05);观察组术后皮质醇(Cor)、促肾上腺皮质激素(ACTH)、椎体前缘高度压缩比、椎体后凸Cobb角与对照组比较差异明显(P<0.05);观察组术后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)等免疫功能指标明显高于对照组(P<0.05);观察组术后不良事件发生率较对照组低(P<0.05)。结论:经伤椎单侧椎弓根螺钉内固定术不仅可提升手术效果,而且对急性脊柱创伤患者免疫功能影响较小,更利于远期脊柱功能恢复,值得推广。Objective:To investigate the effects of unilateral pedicle screw fixation on immune function and long-term functional recovery in patients with acute spinal trauma.Methods:80 patients with acute spinal trauma admitted to our hospital from October 2021 to February 2024 were selected as the study subjects.They were randomly divided into two groups using a random number table method.The control group received traditional bilateral pedicle screw internal fixation surgery,while the observation group received unilateral pedicle screw internal fixation surgery through the injured vertebra.The surgical effects,immune function,and postoperative adverse events of the two groups of patients were compared.Results:The observation group(surgery,bed rest,hospitalization)had lower time and intraoperative bleeding compared to the control group(P<0.05);There were significant differences in postoperative cortisol(Cor),adrenocorticotropic hormone(ACTH),anterior vertebral height compression ratio,and Cobb angle of vertebral kyphosis between the observation group and the control group(P<0.05);The postoperative immune function indicators such as CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the observation group were significantly higher than those in the control group(P<0.05);The incidence of postoperative adverse events in the observation group was lower than that in the control group(P<0.05).Conclusion:Unilateral pedicle screw internal fixation of the injured vertebra can not only improve the surgical effect,but also have a smaller impact on the immune function of patients with acute spinal trauma,which is more conducive to long-term spinal function recovery and is worth promoting.

关 键 词：经伤椎单侧椎弓根螺钉内固定术 急性脊柱创伤 围术期指标 手术效果 免疫功能 

分 类 号：R681.5[医药卫生—骨科学]