回植微型钛板内固定治疗椎管肿瘤的近远期疗效及预后影响因素分析  

Analysis of Short-and Long Term Efficacy and Prognostic Factors in the Treatment of Spinal Canal Tumors with Miniature Titanium Plate Implantation and Internal Fixation

作　　者：李超峰 魏文渊 韩超 邓国华 别小华[1] 薛俊刚 LI Chao-feng;WEIWen-yuan;HAN Chao;DENG Guo-hua;BIE Xiao-hua;XUE Jun-gang(Department of Neurosurgery,Honghui Hospital Affiliated to Xi'an Jiaotong University School of Medicine,Xi'an,Shaanxi,710054,China)

机构地区：[1]西安交通大学医学院附属红会医院神经外科,陕西西安710054

出　　处：《现代生物医学进展》2024年第22期4275-4277,4313,共4页Progress in Modern Biomedicine

基　　金：陕西省重点研发项目(023-YBSF-088)。

摘　　要：目的:探讨回植微型钛板内固定治疗椎管肿瘤的近远期疗效及预后影响因素。方法:选取我院2020.1~2023.1收治的78例采取回植微型钛板内固定治疗的椎管肿瘤患者。记录患者基础资料,随访1年,记录脊柱稳定性及腰椎功能恢复情况。将9例疗效无效和16例远期脊柱不稳定患者(去除5例重复)共20例归为预后不良组,其余58例患者为预后良好组。对比两组临床情况,采用logistics回归模型分析预后影响因素。结果:78例患者平均手术时间为(182.43±17.35)min,术中出血量为(245.24±48.35)mL,住院时间为(23.14±4.25)d,总有效率为88.46%,并发症发生率为6.41%;术后1年随访显示,脊柱稳定率76.92%,SFI与JOA评分均高于手术前(P<0.05);预后良好组与预后不良组肿瘤直径、性质、术前肌力、肿瘤切除、术后激素使用对比差异显著(P<0.05);肿瘤直径、性质、术前肌力、术后激素使用为独立影响因素(P<0.05)。结论:回植微型钛板内固定治疗椎管肿瘤疗效显著,改善患者腰椎功能,且术后并发症可控,但预后受肿瘤直径、性质、术前肌力、术后激素使用的影响。Objective:To investigate the short-term and long-term efficacy and prognostic factors of replantation of mini-titanium plate for internal fixation of spinal canal tumors.Methods:A total of 78 patients with spinal canal tumor who were treated with micro-titanium plate internal fixation were selected from 2020.1 to 2023.1 in our hospital.The basic data of the patients were recorded,followed up for 1 year,and the spinal stability and lumbar function recovery were recorded.A total of 20 patients(9 patients with ineffective response and 16 patients with long-term spinal instability)were classified as the poor prognosis group,and the remaining 58 patients were classified as the good prognosis group.The clinical conditions of the two groups were compared,and the prognostic factors were analyzed by logistics regression model.Results:The average operation time of 78 patients was(182.43±17.35)min,the intraoperative blood loss was(245.24±48.35)mL,the hospital stay was(23.14±4.25)d,the total effective rate was 88.46%,and the complication rate was 6.41%.The 1-year follow-up showed that the spinal stability rate was 76.92%,SFI and JOA scores were higher than those before operation(P<0.05).Good prognosis with poor prognosis group tumor diameter,nature,preoperative muscle,tumor resection,postoperative hormone use contrast significant difference(P<0.05);Tumor diameter,nature,preoperative muscle strength and postoperative hormone use were independent factors(P<0.05).Conclusion:Replanting micro-titanium plate internal fixation for spinal canal tumors is effective,improves the function of lumbar spine,and the postoperative complications are controllable.However,the prognosis is affected by the tumor diameter,nature,preoperative muscle strength,and postoperative hormone use.

关 键 词：回植微型钛板内固定 椎管肿瘤 近远期疗效 影响因素 

分 类 号：R739.4[医药卫生—肿瘤]