不同入路内固定融合术在380例脊柱骨折中的应用观察

Clinical observation of spinal fracture treated with different internal fixation 380 cases

目的探究不同入路内固定融合术在脊柱骨折中的应用。方法选取南阳医学高等专科学校第一附属医院2013年3月-2017年3月收治的380例脊柱骨折患者,按随机数表法分为观察组(n=190)与对照组(n=190)。观察组患者实施后路内固定融合术,对照组患者则实施前路内固定融合术。比较手术前后两组伤椎形态变化,分析两组围术期相关指标、并发症发生情况及疗效差异。结果术后即刻,观察组伤椎前缘高度(94.1±3.9)%,明显高于同期对照组(91.6±3.5)%,组间对比差异有统计学意义(P均<0.05),Cobb角度则明显低于同期对照组(P均<0.05)。观察组患者围术期相关指标均明显少于对照组(P均<0.05)。术后1周内,观察组患者各项并发症发生率均明显低于对照组(P均<0.05)。术后6个月时,观察组治疗有效率97.2%,明显高于对照组(87.9%),组间对比差异有统计学意义(P<0.05)。结论后方入路内固定融合术治疗脊柱骨折效果更为突出,对改善患者预后有利。

Objective To explore the application of different approaches of internal fixation in spinal fracture. Methods Totally 380 patients with spinal fractures admitted to the first affiliated hospital of nanyang medical college from March 2013 to March 2017 were selected and divided into observation group(n=190) and control group(n=190) according to the random number table method. Patients in the observation group received posterior internal fixation and fusion, while patients in the control group received anterior internal fixation and fusion. The morphological changes of injured vertebra before and after operation were compared between the two groups.Results Immediately after the operation, the anterior edge height of injured vertebra in the observation group was(94.1±3.9)%, significantly higher than that of the control group at the same time(91.6±3.5)%, with statistically significant differences between the groups(all P<0.05), and the Cobb Angle was significantly lower than that of the control group at the same time(all P<0.05). The perioperative indexes of the observation group were significantly lower than those of the control group(P<0.05). Within 1 week after surgery, the incidence of all complications in the observation group was significantly lower than that of the control group(P<0.05). Six months after the operation, the effective rate of the observation group was 97.2%, significantly higher than that of the control group(87.9%), and the difference between groups was statistically significant(P<0.05). Conclusion Posterior approach internal fixation is more effective in the treatment of spinal fracture, which is beneficial to improve the prognosis of patients.