彭東
[摘要] 目的 對比分析脊柱骨折患者采用單純內(nèi)固定、內(nèi)固定聯(lián)合椎體成形術(shù)治療的效果。方法 方便選取該院2017年4月—2019年4月收治的脊柱骨折患者70例,隨機(jī)分為兩組,各35例,對照組35例行單純內(nèi)固定治療,觀察組35例行內(nèi)固定聯(lián)合椎體成形術(shù)治療,對比兩組手術(shù)治療效果。結(jié)果 觀察組治療優(yōu)良率顯著高于對照組(94.29% vs 71.43%)(χ2=6.437,P<0.05);觀察組和對照組的術(shù)中失血量和住院時間分別為(57.63±12.81)mL、(8.68±1.36)d,均顯著少于對照組(t=74.002、10.660,P<0.05),觀察組手術(shù)時間為(94.36±10.56)h,顯著多于對照組(t=2.731,P<0.05);觀察組治療后的Cobb's角、傷椎高度為(17.33±3.10)°、(1.85±0.41)cm,與對照組相當(dāng)(t=0.367、0.202,P>0.05);觀察組椎體后緣高度壓縮率和椎體前緣高度壓縮率分別為(12.33±3.65)%、(3.02±0.58)%,均顯著少于對照組(t=6.092、18.809,P<0.05);觀察組術(shù)后并發(fā)癥發(fā)生率顯著少于對照組(2.86% vs 11.43%)(χ2=5.938,P<0.05)。結(jié)論 內(nèi)固定聯(lián)合椎體成形術(shù)治療脊柱骨折效果優(yōu)于單純內(nèi)固定手術(shù)。
[關(guān)鍵詞] 內(nèi)固定手術(shù);療效;椎體成形術(shù);脊柱骨折
[中圖分類號] R5 ? ? ? ? ?[文獻(xiàn)標(biāo)識碼] A ? ? ? ? ?[文章編號] 1674-0742(2020)07(a)-0062-03
[Abstract] Objective To compare and analyze the effects of simple internal fixation, internal fixation combined with vertebroplasty in patients with spinal fractures. Methods A total of 70 patients with spinal fractures admitted to the hospital from April 2017 to April 2019 were convenient selection randomly divided into two groups, 35 cases in each, 35 cases in the control group were treated with internal fixation alone, and 35 cases in the observation group were treated with internal fixation vertebroplasty treatment, comparing the effects of surgical treatment between the two groups. Results The excellent and good rate of treatment in the observation group was significantly higher than that in the control group (94.29% vs 71.43%) (χ2=6.437, P <0.05); the intraoperative blood loss and hospital stay in the observation group and control group were (57.63±12.81) mL, (8.68±1.36) d, were significantly less than the control group (t=74.002, 10.660, P<0.05), the operation time of the observation group was (94.36±10.56)h, significantly more than the control group (t=2.731, P<0.05); Cobb's angle and injured vertebral height of the observation group after treatment were (17.33±3.10) ° and (1.85±0.41) cm, which was equivalent to the control group (t=0.367, 0.202, P> 0.05); observation group posterior vertebral body height compression rate and the anterior vertebral body edge compression rate were (12.33±3.65)% and (3.02±0.58)%, respectively, which were significantly less than the control group (t=6.092, 18.809, P<0.05); observation group of the postoperative complication rate was statistically significantly less than the control group (2.86% vs 11.43%)(χ2=5.938, P<0.05); Conclusion The effect of internal fixation combined with vertebroplasty in the treatment of spinal fractures is better than simple internal fixation .
綜上所述,對于脊柱骨折患者,給予內(nèi)固定聯(lián)合椎體成形術(shù)治療效果優(yōu)于單純內(nèi)固定手術(shù)治療,具有創(chuàng)傷小、出血量少、住院時間短、并發(fā)癥少的優(yōu)點(diǎn)。
[參考文獻(xiàn)]
[1] ?湯秋賢,龔燕華.后路經(jīng)椎弓根內(nèi)固定聯(lián)合椎體成形術(shù)對老年胸腰段脊椎骨折患者治療效果觀察[J].齊齊哈爾醫(yī)學(xué)院學(xué)報,2015,36(13):1921-1922.
[2] ?李會東,馮樹霞,韓俊成,等.微創(chuàng)椎弓根內(nèi)固定聯(lián)合經(jīng)皮穿刺椎體成形術(shù)治療胸腰椎骨質(zhì)疏松性爆裂性骨折的臨床研究[J].中國臨床醫(yī)生雜志,2019,47(7):824-826.
[3] ?吳雪松.椎體成形術(shù)聯(lián)合后路椎弓根內(nèi)固定對老年胸腰段脊柱骨折療效觀察[J].中外醫(yī)學(xué)研究,2019,17(10):18-20.
[4] ?陳旺,胡勝利,嚴(yán)浩.單純內(nèi)固定與內(nèi)固定結(jié)合椎體成形術(shù)治療脊柱骨折的臨床效果體會[J].中醫(yī)臨床研究,2019,11(6):126-127.
[5] ?李程錦.單純內(nèi)固定與內(nèi)固定結(jié)合椎體成形術(shù)治療脊柱骨折的臨床療效分析[J].內(nèi)蒙古醫(yī)學(xué)雜志,2018,50(10):1218-1219.
[6] ?李佳,王磊,陳華.經(jīng)椎弓根內(nèi)固定術(shù)聯(lián)合椎體成形術(shù)治療創(chuàng)傷性胸腰段脊柱骨折[J].中國臨床研究,2018,31(10):1383-1386.
[7] ?于東方,王祥善,張華,等.經(jīng)皮椎體成形術(shù)后手術(shù)椎體再骨折的病因、治療及預(yù)防[J].中醫(yī)正骨,2018,30(10):69-73.
[8] ?郭濤,魏人前,鄧睿.后路經(jīng)椎弓根內(nèi)固定結(jié)合椎體成形術(shù)治療老年胸腰段脊椎骨折的療效觀察[J].川北醫(yī)學(xué)院學(xué)報,2016,31(3):383-385.
[9] ?黃志虎,張羽,張宣,等.內(nèi)固定結(jié)合椎體成形術(shù)對脊柱骨折患者Cobbs角、椎體前緣及后緣高度壓縮率的影響研究[J].實(shí)用心腦肺血管病雜志,2016,24(S1):97-98.
[10] ?馬輝,孫建強(qiáng),莫濤,等.內(nèi)固定結(jié)合椎體成形術(shù)對脊柱骨折患者Cobb′s角、椎體高度壓縮率及生活質(zhì)量的影響[J].廣東醫(yī)學(xué),2019,40(15):2201-2205.
(收稿日期:2020-04-03)