摘要
目的探讨单齿状突螺钉与双齿状突螺钉固定治疗齿状突Ⅱ型骨折的临床效果。方法选择2014年1月～2015年1月于曲靖市第一人民医院就诊的齿状突Ⅱ型骨折患者42例，采用随机数字表法分为两组，各21例。研究组给予双齿状突螺钉固定，对照组给予单齿状突螺钉固定，记录两组患者手术时间、术中出血量、愈合时间及日本骨科协会评估治疗分数（JOA评分）情况；术后1周，观察患者术后恢复情况，包括屈伸功能角度、侧屈角度、轴向旋转功能角度；术后1年随访，进行X线检查。结果两组患者JOA评分比较，研究组明显高于对照组，差异有统计学意义（P〈0．05）。术后1周，研究组屈伸功能角度、侧屈角度、轴向旋转功能角度均大于对照组，差异有统计学意义（P〈0．05）。研究组术后1年随访显示所有患者骨折均获骨性愈合，颈部旋转活动范围均正常或近正常；所有患者齿状突螺钉位置良好，固定稳定，患者咽部无异物感，无螺钉松动断裂现象。对照组螺钉无折断，松动、脱出或骨质内豁出等共计3例，无骨折再移位，无相应神经症状出现或加重。结论双齿状突螺钉固定治疗齿状突Ⅱ型骨折效果较好，骨折愈合率高，能较好地保持颈部旋转的活动度，患者无颈部活动受限体征，是一种安全有效的手术方法，值得临床推广。
Objective To discuss the clinical effect of single dentate screw and double dentate screw in the treatment of Ⅱ type odontoid fracture. Methods 42 cases of patients witti Ⅱ type odontoid fracture in First People＇s Hospital of Qujing City from January 2014 to January 2015 were chosen and randomly divided into two groups, each group had 21 cases. The study group was given double dentate screws treatment, the control group was given single dentate screws treatment. The operation time, amount of intraoperative bleeding, score （JOA score） were recorded in patients of the two groups. The healing time and the Japanese orthopedic association function team flexion angle, lateral flexion angle, axial rotation angle were observed 1 week after operation. X ray examination was given after 1 year of follow-up. Results JOA score in the study group was higher than that in the control group, the difference was statistically significant （P 〈 0.05）. The function team flexion angle, lateral flexion angle, axial rotation angle in the study group were greater than those in the control group, the differences were statistically significant （P 〈 0.05）. The fracture in the study group after a year of follow-up was bony healing, neck rotation range was normal or nearly normal; all patients＂ dentate screw position was good, fixed stable; patients had no pharyngeal foreign body sensation; no loose screw fracture phenomenon occurred. The screw had no broken in the control group, screws in 3 Cases had loose, out or bone, within the bone, and had no fracture shift again, no corresponding neurological symptoms Occurred or worse. Conclusion The effect of double dentate screws in the treatment of 11 type odontoid fracture is good, with high fracture healing rate, it can keep the neck rotation motion and patients without limited neck activity signs. It is a kind of safe and effective surgical method, which is worthy for clinical promoting.
出处
《中国医药导报》
CAS
2016年第24期101-104,共4页
China Medical Herald
