小切口手术治疗脊柱创伤的效果及安全性

Efficacy and Safety of Small Incision Surgical Treatment for Spinal Trauma

目的观察小切口手术治疗脊柱创伤的效果及安全性。方法选取2013年1月至2015年1月重庆市大足区人民医院收治的脊柱创伤患者68例,按照随机数字表法分为观察组(34例)和对照组(34例)。对照组行传统开放手术治疗,观察组行小切口手术治疗。比较两组患者手术前后的脊柱后凸Cobb's角及伤椎椎体前缘高度变化,观察两组患者的术中、术后情况,调查两组患者术后的满意度。结果观察组患者的手术时间、术后活动时间、住院时间均显著短于对照组[(121±6)min比(181±11)min,(28±13)h比(37±10)h,(8±3)d比(16±7)d],术中出血量显著少于对照组[(122±5)mL比(287±7)mL],疼痛评分显著低于对照组[(3.1±1.1)分比(7.6±2.1)分],差异有统计学意义(P<0.01);术后,观察组患者的Cobb's角和前缘压缩高度显著低于对照组[(6.1±2.2)°比(12.1±5.8)°,(5.8±1.9)%比(13.5±2.8)%],观察组患者的满意率显著高于对照组[82.4%(28/34)比44.1%(15/34)],观察组患者镇痛药使用率和并发症发生率显著低于对照组[5.9%(2/34)比47.1%(16/34),2.9%(1/34)比20.6%(7/34)],差异有统计学意义(P<0.05)。结论脊柱创伤患者应用小切口手术进行治疗,手术时间、住院时间均较短,术中出血量较少,并且疼痛程度较轻,切口感染率和术后并发症发生率较低,其疗效良好,安全性较高,值得广泛推广使用。

Objective To study the efficacy and safety of small incision surgery for spinal traumas. Methods Total of 68 patients with spinal trauma in Chongqing Dazu District People＇s Hospital from Jan. 2013 to Jan. 2015 were included in the study and divided into an observation group（34 cases） and a control group（34 cases）according to the random number table method. The control group underwent conventional open surgery,while the observation group was given small incision surgery. The vertebral kyphosis Cobb＇s angle and vertebral height changes were compared before and after surgery. After surgery, the patient satisfaction degree was compared. Results The operation time, postoperative activity time, length of hospital stay of the observation group were significantly shorter than the control group[ （ 121±6） rain vs （ 181±11 ） min, （28 ±13） h vs （37±10） h, （8±3） d vs （ 16±7） d] ,the blood loss was significantly less than the control group[ （122±5） mL vs （287 ±7） mL] ,and the pain score was significantly lower than the control group [ （3.1±1.1 ） point vs （7.6±2.1 ） point ], the differences were statistically significant （ P 〈0.05 ）. After surgery,Cobb＇s angle and the leading edge compression height of the observation group were significantly lower than the control group[（6.1±2.2）% vs （12.1±5.8）%, （5.8±1.9）% vs （13.5 ±2.8）%], patient satisfaction degree of the observation group was significantly higher than the control group [ 82. 4% （28/34） vs 44. 1% （15/34）], analgesic usage and the complication rate were significantly lower than the control group [ 5.9% （2/34） vs 47. 1% （ 16/34 ）, 2. 9% （ 1/34 ） vs 20. 6% （ 7/34 ） ], the differences were statistically significant（P 〈 O. 05）. Conclusion Small incision treatment for spinal trauma requires shorter surgery time and hospital stay ,is with less blood loss and pain,lower wound infection and postoperative complications rate, thus can be concluded as with good effect and high safety, and worthy of wide application.