经皮后路椎弓根螺钉固定治疗脊柱胸腰段骨折的临床疗效分析

Analysis of Clinical Efficacy of Percutaneous Posterior Pedicle Screw Fixation for Spinal Thoracolumbar Fractures

目的观察经皮后路椎弓根螺钉固定治疗脊柱胸腰段骨折的临床疗效。方法观察样本都是从该院收入的脊柱胸腰段骨折患者中方便选取,合计68例,时段为2017年5月—2018年5月。依据“随机数字表法”实现每组的均匀分配,其中参照组(n=34例)选择开放椎弓根螺钉固定治疗;观察组(n=34例)选择经皮后路椎弓根螺钉固定治疗。对比患者的有效率、并发症产生情况、手术时间外的各项手术情况。结果观察组的总有效率97.05%高于参照组70.58%(χ^2=8.785、P=0.003);且并发症的产生5.88%少于参照组23.53%(χ^2=6.275、P=0.012);切口长度:参照组(16.3±0.8)cm,观察组(1.4±0.1)cm。比较下,观察组的切口长度更短(t=107.763;P=0.000)。术中出血量:参照组(261.3±31.8)mL,观察组(81.7±16.1)mL。比较下,观察组的术中出血量更少(t=29.381;P=0.000)。手术时间:参照组(71.3±10.4)min,观察组(67.1±10.7)min。比较下,观察组的手术时间更短(t=1.641;P=0.106)。术后引流量:参照组(271.1±21.2)mL,观察组(0±0)ml。显然,对比后观察组的术后引流量无,优于参照组(t=74.565;P=0.000)。止痛针使用时间:参照组(3.6±0.8)d,观察组(2.1±0.7)d。比较后,观察组对止痛针使用时间更少(t=8.228;P=0.000)。住院时间:参照组(12.5±1.1)d,观察组(5.2±1.0)d。比较后,观察组住院时间更短(t=28.633;P=0.000)。结论脊柱胸腰段骨折患者选择经皮后路椎弓根螺钉固定治疗的临床疗效优于开放椎弓根螺钉固定治疗结局,是值得借鉴的一种治疗方法。

Objective To observe the clinical efficacy of percutaneous posterior pedicle screw fixation for spinal thoracolumbar fractures.Methods The observation samples were convenient selected from patients with spinal thoracolumbar fractures in the hospital.A total of 68 patients were selected from May 2017 to May 2018.According to the"random number table method",each group was evenly distributed.The reference group(n=34 cases)selected open pedicle screw fixation;the observation group(n=34 cases)selected percutaneous posterior pedicle screw fixation treatment.Patients were compared for their effectiveness,complications,and conditions outside the time of surgery.Results The total effective rate in the observation group was 97.05%higher than 70.58%in the reference group(χ^2=8.785,P=0.003);and the incidence of complications was 5.88%less than 23.53%in the reference group(χ^2=6.275,P=0.012);the incision length:reference group(16.3±0.8)cm,observation group(1.4±0.1)cm.By comparison,the incision length in the observation group was shorter(t=107.763;P=0.000).Intraoperative blood loss:reference group(261.3±31.8)mL,observation group(81.7±16.1)mL.By comparison,the intraoperative blood loss was smaller in the observation group(t=29.381;P=0.000).Operation time:reference group(71.3±10.4)min,observation group(67.1±10.7)min.By comparison,the operation time in the observation group was shorter(t=1.641;P=0.106).Postoperative drainage:reference group(271.1±21.2)ml,observation group(0.0±0.0)mL.Obviously,there was no postoperative drainage in the observation group after comparison,which was better than the reference group(t=74.565;P=0.000).Analgesic needle use time:reference group(3.6±0.8)d,observation group(2.1±0.7)d.After comparison,the observation group used the painkiller for less time(t=8.228;P=0.000).Length of hospital stay:reference group(12.5±1.1)d,observation group(5.2±1.0)days.After comparison,the hospital stay was shorter in the observation group(t=28.633;P=0.000).Conclusion The clinical efficacy of percutaneous posterior pedicle screw fixation in patients with spinal thoracolumbar fractures is better than that of open pedicle screw fixation.