Wiltse肌间隙入路在胸腰椎骨折中的应用效果及对创伤反应、稳定性的影响  

Application Effect of Wiltse Intermusclar Approach in the Treatment of Thoracolumbar Fracture and Its Influence on Trauma Response,Stability

作　　者：吴久海 郑弟 谭志辉 WU Jiuhai;ZHENG Di;TAN Zhihui(Department of Orthopedics,Yichang Fifth People's Hospital,Yichang 443000,China)

机构地区：[1]宜昌市第五人民医院骨科,湖北宜昌443000

出　　处：《中国医学创新》2025年第10期75-79,共5页Medical Innovation of China

摘　　要：目的:探究Wiltse肌间隙入路在胸腰椎骨折中的应用效果及对创伤反应、稳定性的影响。方法:选择2021年10月—2024年1月宜昌市第五人民医院收治的80例胸腰椎骨折患者,根据随机数字表法分为两组,各40例。对照组行后正中入路手术治疗,观察组行Wiltse肌间隙入路手术治疗。比较两组的手术时间、术中出血量、住院时间、并发症发生率、疼痛情况[视觉模拟评分法(VAS)评分]、创伤反应指标[C反应蛋白(CRP)、促肾上腺皮质激素(ACTH)及瘦素(LEP)]及稳定性指标(伤椎楔变角、后凸Cobb角及伤椎前缘高度)。结果:观察组手术时间及住院时间均短于对照组,术中出血量显著少于对照组,并发症发生率显著低于对照组,差异均有统计学意义(P<0.05)。术前,两组VAS评分、创伤反应指标及稳定性指标比较,差异均无统计学意义(P>0.05);术后1、3、5 d,观察组VAS评分、CRP、ACTH、LEP均显著低于对照组,差异均有统计学意义(P<0.05);术后1周、1个月及6个月,两组伤椎楔变角、后凸Cobb角均低于术前,伤椎前缘高度显著高于术前,差异均有统计学意义(P<0.05)。结论:Wiltse肌间隙入路在胸腰椎骨折中的疗效较好,且可更为有效地控制机体的创伤反应,且稳定性较好。Objective:To explore the application effect of Wiltse intermuscular approach in thoracolumbar fracture and its influence on trauma response and stability.Method:A total of 80 patients with thoracolumbar fracture admitted to Yichang Fifth People's Hospital from October 2021 to January 2024 were selected and divided into two groups according to the random number table,with 40 patients in each group.The control group was treated with posterior median approach,and the observation group was treated with Wiltse intermuscular approach.The operative time,intraoperative blood loss,length of hospital stay,complication rate,pain situation[visual analogue scale(VAS)score],trauma response indicators[C reactive protein(CRP),adrenocorticotropin(ACTH)and leptin(LEP)]and stability indicators(angle of wedge,kyphotic Cobb angle and anterior vertebra of injured vertebra)were compared between the two groups.Result:The operation time and hospital stay in the observation group were shorter than those in the control group,the amount of intraoperative blood loss was significantly lower than that in the control group,and the incidence of complications was significantly lower than that in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in VAS scores,trauma response indexes and stability indexes between the two groups(P>0.05).At 1,3 and 5 d after operation,VAS scores,CRP,ACTH and LEP in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).At 1 week,1 month and 6 months after surgery,the wedge variation angle and kyphotic Cobb angle of the injured vertebra were significantly lower than those before surgery,and the anterior edge height of the injured vertebra was significantly higher than that before surgery,the differences were statistically significant(P<0.05).Conclusion:The Wiltse intermuscular approach is effective in the treatment of thoracolumbar fractures,and can control the body's traum

关 键 词：Wiltse肌间隙入路 胸腰椎骨折 创伤反应 稳定性 

分 类 号：R687.3[医药卫生—骨科学]