经伤椎植入固定螺钉与万向螺钉对胸腰椎骨折患者伤椎恢复、疼痛应激指标及功能恢复的影响比较

Comparison of the effects of implantation of fixed screws and universal screws through the injured vertebra on the recovery of injured vertebrae,pain stress indexes and functional recovery in patients with thoracolumbar fractures

目的比较经伤椎植入固定螺钉与万向螺钉对胸腰椎骨折患者伤椎恢复、疼痛应激指标及功能恢复的影响。方法选取2019年1月至2021年1月我院收治的100例胸腰椎骨折患者为研究对象,以抽签法将其随机分为A组和B组,各50例。A组经伤椎植入固定螺钉,B组经伤椎植入万向螺钉。比较两组的治疗效果。结果A组的手术时间长于B组,术中出血量多于B组(P<0.05)。术后1周、6个月,A组的伤椎前缘高度比高于B组,Cobb角小于B组(P<0.05)。术前及术后1周、6个月,两组的皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平无明显差异(P>0.05)。术后1周,A组的Oswestry功能障碍指数(ODI)评分低于B组(P<0.05)。结论经伤椎植入固定螺钉与万向螺钉对胸腰椎骨折患者术后疼痛应激反应的影响相当,且其均能取得较好的功能恢复效果,但经伤椎植入固定螺钉固定稳定,在伤椎恢复上具有一定优势。

Objective To compare the effects of implantation of fixed screws and universal screws through the injured vertebra on the recovery of injured vertebrae,pain stress indexes and functional recovery in patients with thoracolumbar fractures.Methods From January 2019 to January 2021,100 patients with thoracolumbar fractures admitted in our hospital were selected as the research objects.The patients were randomly divided into group A and group B by drawing lots,with 50 cases in each group.The group A was implanted with fixed screws through the injured vertebra,and the group B was implanted with universal screws through the injured vertebra.The therapeutic effects of the two groups were compared.Results The operation time of the group A was longer than that of the group B,and the intraoperative blood loss was more than that of the group B(P<0.05).At 1 week and 6 months after operation,the ratio of anterior height of injured vertebrae of the group A was higher than that of the group B,and the Cobb angle was smaller than that of the group B(P<0.05).There were no significant differences in cortisol(Cor)and adrenocorticotropic hormone(ACTH)levels between the two groups before operation,1 week and 6 months after operation(P>0.05).One week after operation,the Oswestry Disability Index(ODI)score of the group A was lower than that of the group B(P<0.05).Conclusion Implantation of fixed screws through the injured vertebra has the same effect as universal screws on postoperative pain stress response in patients with thoracolumbar fractures,and both of them can achieve better functional recovery.However,implantation of fixed screws through the injured vertebra is stable and has certain advantages in the recovery of the injured vertebra.