脊柱创伤合并脊髓损伤的临床手术治疗方法及预后效果探讨

Clinical Surgical Treatment and Prognosis of Spinal Trauma Combined with Spinal Cord Injury

目的对脊柱创伤合并脊髓损伤的临床手术治疗方法及预后效果进行研究。方法经过对该院2015年5月—2018年5月采取手术治疗的80例脊柱创伤合并脊髓损伤患者临床资料展开回顾分析,对照组选择单纯手术治疗,观察组选择大剂量激素冲剂加手术治疗,对比两组的椎体转变效果、Harris评分、生活自理能力评分以及治疗总有效率。结果观察组椎体转变效果椎体前缘压缩高度(6.65±2.21)mm、椎体后缘压缩高度(5.87±2.64)mm、Cobb’s角(8.63±2.52)°优于对照组椎体前缘压缩高度(35.12±7.98)mm、椎体后缘压缩高度(23.35±6.22)mm、Cobb’s角(21.37±5.86)°,两组相比差异有统计学意义(t=21.74、11.36、12.63,P<0.05);观察组Harris评分(66.12±3.98)分优于对照组(5.69±2.27)分,两组相比差异有统计学意义(t=83.41,P<0.05);观察组生活自理能力评分[穿衣(8.92±2.34)分、进食(8.64±2.48)分、平地行走(14.34±2.97)分、床椅转移(13.12±2.98)分、控制大小便(15.35±4.71)分]优于对照组[穿衣(3.55±2.61)分、进食(3.17±2.12)分、平地行走(1.63±3.12)分、床椅转移(1.75±3.21)分、控制大小便(2.87±6.13)分],两组相比差异有统计学意义(t=9.68、10.60、18.66、16.41、10.21,P<0.05);观察组治疗总有效率(95.00%)高于对照组(80.00%)(χ2=4.114,P<0.05)。结论脊柱创伤合并脊髓损伤患者在接受大剂量激素冲剂加手术治疗后,其椎体转变以及预后效果均较好,显著地提升了患者的生活自理能力,且神经功能与肌力恢复较好,值得在临床应用中加以推广。

Objective To study the clinical surgical treatment and prognosis of spinal trauma combined with spinal cord injury. Methods The clinical data of 80 patients with spinal trauma and spinal cord injury who underwent surgical treatment from May 2015 to May 2018 were retrospectively analyzed. The control group was treated with surgery alone. The observation group chose high-dose steroids plus surgery. The vertebral transformation effect, Harris score, self-care ability score and total treatment efficiency were compared between the two groups. Results The vertebral body transformation effect of the observation group the compression height of the anterior vertebral body was (6.65±2.21)mm, the compression height of the posterior margin of the vertebral body was (5.87±2.64)mm, and the Cobb's angle was (8.63±2.52)°. The compression height of the vertebral body was (35.12±7.98)mm, the compression height of the posterior edge of the vertebral body was (23.35±6.22)mm, and the Cobb's angle was (21.37±5.86)°. The difference between the two groups was significant.(t=21.74, 11.36, 12.63, P﹤0.05); the observation group Harris score (66.12±3.98)points was superior to the control group(5.69±2.27)points. The difference was significant between the two groups(t=83.41, P﹤0.05). The self-care ability score of the observation group[dressing (8.92±2.34)points, eating (8.64±2.48)points, walking on the ground (14.34±2.97)points, bed chair transfer (13.12±2.98)points, control urination(15.35±4.71)points] better than the control group [dressing (3.55±2.61)points, eating (3.17±2.12)points, walking on the ground (1.63±3.12)points, bed chair transfer (1.75±3.21)points, controlling the bowel movement(2.87±6.13)points], the difference was significant between the two groups (t=9.68, 10.60, 18.66, 16.41, 10.21, P﹤0.05). The total effective rate of the observation group (95.00%) was higher than that of the control group (80.00%)(χ2=4.114, P﹤0.05). Conclusion Patients with spinal trauma and spinal cord injury have better vertebral body transformation and prognosis after receiving high-dose hormonal granules plus surgery, which significantly improves the patient's self-care ability and better recovery of nerve function and muscle strength. It is worth promoting in clinical applications.