后路内固定融合术治疗腰段脊柱骨折的效果及其对应激指标的影响

Effects of posterior internal fixation and fusion on lumbar spine fracture and its influence on stress indexes

目的:探讨后路内固定融合术治疗腰段脊柱骨折的效果及其对血清应激指标的影响。方法:回顾性分析2016年2月至2019年12月聊城市第二人民医院收治的80例腰段脊柱骨折患者的临床资料,依据治疗方案分为观察组(行后路内固定融合术,40例)与对照组(行后路内固定非融合术,40例)。比较两组手术前后Cobb角,椎体前、后缘高度及应激指标[皮质醇(Cor)、促肾上腺皮质激素(ACTH)、肿瘤坏死因子-α(TNF-α)]。结果:术前,两组Cobb角与椎体前、后缘高度比较,差异未见统计学意义(t=0.326、0.639、0.173,P=0.745、0.525、0.863);术后,两组Cobb角缩小,椎体前、后缘高度增加,且观察组变化幅度大于对照组,差异有统计学意义(P<0.05)。术前,两组应激指标比较差异未见统计学意义(P>0.05);术后,两组Cor、ACTH、TNF-α水平均有所升高,但观察组升高幅度小于对照组,差异有统计学意义(P<0.05)。结论:后路内固定融合术可改善腰段脊柱骨折患者Cobb角及椎体前、后缘高度,稳定应激指标水平。

Objective To investigate the effects of posterior internal fixation and fusion on lumbar spine fracture,and its influence on serum stress indexes.Methods The clinical data from 80 patients with lumbar spine fracture admitted to the Second People’s Hospital of Liaocheng from February 2016 to December 2019 were analyzed retrospectively.According to the treatment plans,patients were divided into observation group(40 cases,treated by posterior internal fixation and fusion)and control group(40 cases,treated by posterior internal fixation without fusion).Before and after operation,the Cobb angle,height of anterior and posterior edge of vertebral body,stress indexes,including cortisol(Cor),adreno cortico tropic hormone(ACTH),tumor necrosis factor-α(TNF-α),were compared between the two groups.Results Before operation,there was no significant difference between the two groups in the Cobb angle,height of anterior and posterior edge of vertebral body(t=0.326,0.639,0.173;P=0.745,0.525,0.863).After operation,Cobb angle of the two groups decreased,the height of the anterior and posterior vertebral bodies of the two groups increased,and the changes of these indexes in the observation group were greater than those in the control group(P<0.05).Before operation,there was no significant difference in stress indexes between the two groups(P>0.05).After operation,the levels of Cor,ACTH,TNF-αin the two groups increased,but the increasing range of each index in the observation group were smaller than those in the control group(P<0.05).Conclusions Posterior internal fixation and fusion can improve the Cobb angle,height of anterior and posterior edge of vertebral body,and stabilize the level of stress indexes.