胸腰段脊柱肿瘤患者采用全椎体切除脊柱重建术治疗的疗效观察

Efficacy of total vertebral vertebrectomy and spinal reconstruction for thoracolumbar spinal tumors

目的探讨胸腰段脊柱肿瘤患者采用全椎体切除脊柱重建术治疗的临床疗效与功能恢复。方法选取2014年6月至2019年1月间四川省安岳县人民医院收治的接受全椎体切除脊柱重建术治疗的86例胸腰段脊柱肿瘤患者进行回顾性分析,观察患者手术过程中的出血量、手术时间及不良反应。采用语言模拟疼痛评分(VRS)评估患者疼痛状况,采用Frankel分级评估患者的脊柱稳定性和神经功能恢复情况。结果患者手术时间为(285.6±72.5)min,手术过程中出血量为700~1700(961.6±219.1)ml。术中并发症:血肿形成1例,胸膜破裂2例。术后并发症:泌尿系统感染4例,胸腔积液3例,伤口脂肪液化2例,肺部感染2例。并发症总发生率为16.3%。患者术后疼痛、脊柱稳定性及神经功能恢复情况较术前均有明显好转,差异有统计学意义(P<0.05)。结论胸腰段脊柱肿瘤患者采用全椎体切除脊柱重建术治疗,效果较好,可减少肿瘤复发率,较好恢复和保留脊髓功能。

Objective To analyze the efficacy of total vertebral vertebrectomy and spinal reconstruction for thoracolumbar spinal tumors and functional recovery.Methods Eighty-six patients with thoracolumbar spinal tumors who underwent total vertebrectomy at Anyue County People’s Hospital from June2014 to January 2019 were selected and retrospectively analyzed.The amount of bleeding and the operation time were observed,and the adverse reactions were recorded.Pain was assessed by verbal rating scale(VRS)and the Frankel grade was used to assess spinal stability and neurological recovery.Results The operation time was 285.6±72.5 min,and the average blood loss during the operation was 700~1700(961.6±219.1)ml.Intraoperative adverse reactions included hematoma in 1 patient and split pleura in 2 patients.Postoperative adverse reactions included urinary tract infection in 4 patients,pleural effusion in 3 patients,wound with fat liquefaction in 2 patients and lung infection in 2 patients.The overall incidence of complications was 16.3%.Postoperative pain,spinal stability and neurological recovery were improved(all P<0.05).Conclusion The efficacy of total vertebral vertebrectomy and spinal reconstruction for thoracolumbar spinal tumors is high,which can significantly reduce the tumor recurrence rate,and restore and retain the function of the spinal cord.