经皮椎弓根钉微创手术治疗脊柱骨折的临床价值分析

Clinical Value Analysis of Minimally Invasive Percutaneous Pedicle Nailing Surgery for Spinal Fractures

目的探讨对脊柱骨折患者采用经皮椎弓根钉微创手术治疗的临床效果。方法选取2018年1月—2021年5月贵州医科大学附属白云医院收治的78例脊柱骨折患者为研究对象,随机分为常规组(采用传统开放性内固定术)和研究组(采用经皮椎弓根钉微创手术),各39例。比较两组患者手术总有效率、炎症反应指标、并发症发生率、影像学参数、手术指标。结果研究组手术总有效率(92.31%)较常规组(69.23%)明显更高,差异有统计学意义(χ^(2)=6.685,P<0.05)。治疗前,两组炎症反应指标对比,差异无统计学意义(P>0.05);治疗后,研究组各炎症反应指标水平均较常规组明显更低,差异有统计学意义(P<0.05)。研究组并发症(下肢深静脉血栓形成、伤口感染以及固定失败)总发生率(5.13%)与常规组(12.82%)比较,差异无统计学意义(P>0.05)。治疗前后,研究组各项影像学参数与常规组比较,差异无统计学意义(P>0.05);研究组术中出血量较常规组明显更少,手术操作时间以及住院治疗时间均较常规组明显更短,差异有统计学意义(P<0.05)。结论经皮椎弓根钉微创手术有效应用,同传统开放性内固定术比较,可显著改善患者治疗效果以及炎症反应指标,减少术中出血量,缩短手术操作时间以及住院治疗时间,促进脊柱骨折患者良好预后。

Objective To explore the clinical effects of minimally invasive percutaneous pedicle screw surgery for spinal fractures.Methods From January 2018 to May 2021,78 patients with spinal fractures admitted to Baiyun Hospital affiliated to Guizhou Medical University were selected as the study subjects.They were randomly divided into a conventional group(using traditional open internal fixation)and a study group(using minimally invasive percutaneous pedicle screw surgery),with 39 patients in each group.The total effective rate,inflammatory response index,complication rate,imaging parameters and surgical indexes were compared between the two groups.Results The total effective rate of surgery in the study group(92.31%)was significantly higher than that in the conventional group(69.23%),the difference was statistically significant(χ^(2)=6.685,P<0.05).Before treatment,there was no statistically significant difference in inflammatory response indicators between the two groups(P>0.05);after treatment,the levels of various inflammatory reaction indicators in the study group were significantly lower than those in the conventional group,the difference was statistically significant(P<0.05).The total incidence of complications(lower limb deep vein thrombosis,wound infection,and fixation failure)in the study group(5.13%)was not significantly different from that in the conventional group(12.82%)(P>0.05).Before and after treatment,there was no significant difference in imaging parameters between the study group and the conventional group(P>0.05);the amount of intraoperative bleeding in the study group was significantly less compared to the conventional group,and the operating time and hospitalization time in the study group were significantly shorter than that in the conventional group,the difference was statistically significant(P<0.05).Conclusion The effective application of the minimally invasive percutaneous pedicle screw surgery,compared with traditional open internal fixation,can significantly improve the treatment effect of patients and inflammatory reaction indicators,reduce intraoperative bleeding,shorten the operation time and hospital treatment time,and promote the good prognosis of patients with spinal fracture.