HPT对重度脊柱侧弯患者的治疗效果及负面影响  

Therapeutic effects and negative effects of HPT on patients with severe scoliosis

作　　者：张亚梁 徐房添 赖凌勇 缪圣旺 周波 ZHANG Ya-liang;XU Fang-tian;LAI Ling-yong;MIAO Sheng-wang;ZHOU Bo(The First Clinical Medical School of Gannan Medical University;Department of Orthopedics,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医科大学第一临床医学院 [2]赣南医科大学第一附属医院骨科,江西赣州341000

出　　处：《赣南医科大学学报》2024年第9期962-966,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市科技局科技计划项目(GZ2018ZSF116)。

摘　　要：各种原因导致的重度脊柱侧弯畸形是一类严重的脊柱疾病,研究表明如果直接矫形手术,治疗难度大、风险高、围手术期并发症多。而术前是否需要辅助牵引及施行何种牵引尚存在争议。本文通过查阅国内外最新研究成果,就术前头盆环牵引(Halo-pelvic traction,HPT)辅助治疗重度脊柱侧弯的疗效及对患者神经、生理、心理等方面的负面影响进行综述。文献复习结果表明,术前辅助行HPT可有效减少重度脊柱畸形的Cobb角,并明显改善肺功能,增加术中矫形效果,减轻手术难度和风险。但牵引过程中也会导致患者生活质量下降,可能发生神经并发症等负面影响。其他牵引方式,如头颅-股骨牵引(Halo-femoral traction,HFT),其装置固定、患者无法移动行走,长时间牵引增加卧床的并发症发生率;头颅-重力牵引(Halo-gravity traction,HGT)最明显的缺点则是牵引力量有限(患者自身重量牵引),牵引效率低。提示术前HPT是一种安全有效的治疗重度脊柱侧弯的辅助手段。Severe scoliosis deformities caused by various reasons are a serious spine disease.Studies have shown that it is difficult in treatment with high risks and complications during the perioperative period to conduct correcting deformity surgery directly.However,it is controversial about whether or what kind of traction is required preoperatively.This article reviews the efficacy of halo-pelvic traction(HPT)for the preoperative adjuvant treatment of severe scoliosis and its negative effects on the nerves,physiology and psychology of patients by reviewing the latest research results at home and abroad.The results of literature review showed that preoperative adjuvant HPT could reduce the cobb angle of severe spinal deformity effectively,improve lung function significantly,and increase the orthopedic effect intraoperatively,reduce the difficulty and risk of surgery.However,HPT may also lead to some negative effects such as the poor quality of life and the possibility of neurological complications during the process.While there are more obvious disadvantages about other traction methods,such as the halo-femoral traction(HFT),the immobilized devices which will lead to being unable to move and walk for patients,and high incidence of bed-rest complications.The most obvious disadvantage of halo-gravity traction(HGT),on the other hand,is the limited traction force(patient's own weight traction)and the low traction efficiency.These results indicate that the preoperative HPT is a safe and effective adjunct treatment for patients with severe scoliosis.

关 键 词：重度脊柱侧弯 头盆环牵引 治疗效果 负面影响 

分 类 号：R68[医药卫生—骨科学]