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经皮椎弓根钉内固定术联合伤椎置钉对胸腰段脊柱骨折患者远期疼痛及功能恢复的影响 被引量:1

Effect of Percutaneous Internal Fixation with Percutaneous Arch Nailing Combined with Injured Spine Nailing on Long-term Pain and Functional Recovery in Patients with Thoracolumbar Spine Fractures
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摘要 目的探讨经皮椎弓根钉内固定术联合伤椎置钉治疗胸腰段脊柱骨折的临床效果及安全性。方法随机选取2020年1月—2021年6月甘肃省临夏州人民医院收治的60例胸腰段脊柱骨折患者作为研究对象,按照随机数表法分为两组,各30例。对照组予以开放后路椎弓根钉内固定术治疗,观察组予以经皮椎弓根钉内固定术联合伤椎置钉治疗,随访至术后6个月。比较两组手术效果。结果观察组手术时间(68.75±5.49)min、术后卧床时间(4.52±1.05)d短于对照组,出血量(98.58±8.79)mL少于对照组,差异有统计学意义(t=3.691、8.764、25.265,P<0.05)。两组术后6个月椎体后凸角低于术前,椎体前缘高度比高于术前,差异有统计学意义(P<0.05);两组术后6个月椎体后凸角、椎体前缘高度比相比,差异无统计学意义(P>0.05)。观察组术后1 d及6个月时VAS评分分别为(5.29±1.14)分、(1.53±0.23)分,均低于对照组,术后6个月ODI评分(10.36±2.15)分低于对照组,差异有统计学意义(t=3.658、6.278、5.116,P<0.05)。两组术后6个月生活质量评分高于术前,且观察组生活质量中生理(86.76±7.29)分、心理(88.58±7.14)分、社会(90.31±8.25)分及环境(89.65±7.29)分等领域评分高于对照组,差异有统计学意义(t=3.707、3.439、3.150、3.727,P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.320,P<0.05)。结论经皮椎弓根钉内固定术联合伤椎置钉治疗胸腰段脊柱骨折效果更佳,能减少手术创伤、缩短卧床时间、加快功能恢复、减轻远期疼痛,且并发症少。 Objective To investigate the clinical effect and safety of percutaneous internal fixation of the pedicle nail combined with injury nailing in the treatment of thoracolumbar segmental spine fractures.Methods 60 patients with thoracolumbar spinal fractures admitted to Linxia Prefecture People's Hospital in Gansu Province from January 2020 to June 2021 were randomly selected as the study subjects.They were divided into two groups using a random number table method,with 30 patients in each group.The control group was treated with open posterior endoprosthetic nailing.The observation group was treated with percutaneous internal fixation of the arch nail combined with nail placement of the injured spine.The follow-up period was up to 6 months after surgery.The surgical results of the two groups were compared.Results In the observation group,the operative time(68.75±5.49)min and postoperative bed time(4.52±1.05)d were shorter than those in the control group,and the bleeding volume(98.58±8.79)mL was less than that in the control group,the difference was statistically significant(t=3.691,8.764,25.265,P<0.05).The posterior convexity angle of the vertebral body at 6 months after surgery was lower than that before surgery,and the height ratio of the anterior edge of the vertebral body was higher than that before surgery in both groups,the difference was statistically sig nificant(P<0.05);there was no statistically significant difference in the posterior convexity angle of vertebral body and height ratio of anterior edge of vertebral body compared with those of the two groups at 6 months after surgery(P>0.05).The VAS scores of the observation group at 1 d and 6 months after surgery were(5.29±1.14)points and(1.53±0.23)points,respectively,which were lower than those of the control group,and the ODI scores(10.36±2.15)points were lower than in the control group at 6 months after surgery,and the differences were statistically significant(t=3.658,6.278,5.116,P<0.05).The quality of life scores at 6 months after surgery were higher than those before surgery in both groups,and the physical(86.76±7.29)points,psychological(88.58±7.14)points,social(90.31±8.25)points and environmental(89.65±7.29)points domains of quality of life were higher in the observation group than in the control group,and the differences were statistically significant(t=3.707,3.439,3.150,3.727,P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=4.320,P<0.05).Conclusion Combining percutaneous internal fixation with injured spine nailing for the treatment of thoracolumbar spinal fractures is more effective,which can reduce surgical trauma,shorten bed rest time,accelerate functional recovery,and reduce long-term pain with fewer complications.
作者 段剑平 DUAN Jianping(Department of Traumatology and Orthopedics,Linxia People's Hospital,Linxia,Gansu Province,731100 China)
出处 《中外医疗》 2023年第3期95-99,共5页 China & Foreign Medical Treatment
关键词 胸腰段脊柱骨折 经皮椎弓根钉内固定 伤椎置钉 疼痛 生活质量 并发症 Thoracolumbar spine fracture Percutaneous internal fixation with arch nail Injured spine nailing Pain Quality of life Complications
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