摘要
目的分析微创经皮椎弓根螺钉内固定对单纯性腰椎骨折患者临床疗效、影像学指标及应激反应的影响。方法选取2017年5月—2019年5月本院治疗的单纯性腰椎骨折120例,根据治疗方式的不同分为研究组(予微创经皮椎弓根螺钉内固定治疗)和对照组(予传统后路开放切开复位短节段椎弓根螺钉内固定治疗),各60例。比较2组临床疗效、围术期指标,手术前后影像学指标(后凸Cobb角、伤椎前缘高度)和应激反应指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肌酸激酶(CK)],以及术后并发症发生情况。结果研究组总有效率显著高于对照组(P<0.01)。术后1周及末次随访时研究组后凸Cobb角、伤椎前缘高度改善情况明显优于对照组,且随治疗时间的延长2组上述指标改善情况更显著,差异有统计学意义(P<0.05,P<0.01)。术后,2组IL-6、CRP、CK水平较术前明显升高,但研究组IL-6、CRP、CK水平较对照组低,差异有统计学意义(P<0.05,P<0.01)。研究组手术时间、术中出血量、术后24 h切口引流量及住院时间均优于对照组(P<0.01)。研究组术后并发症总发生率明显低于对照组(P<0.01)。结论微创经皮椎弓根螺钉内固定治疗单纯性腰椎骨折临床效果显著,可显著减轻机体应激反应,改善后凸Cobb角及伤椎前缘高度,且安全性高。
Objective To analyze effects of minimally invasive pedicle screw fixation on clinical efficacy,imaging indexes and stress reaction of patients with simple fracture of lumbar vertebra.Methods A total of 120 patients with simple fracture of lumbar vertebra treated between May 2017 and May 2019 were divided into research group(n=60,treated with minimally invasive percutaneous pedicle screw fixation)and control group(n=60,treated with traditional posterior open reduction and short-segment pedicle screw fixation).Clinical efficacy,perioperative indexes,imaging indexes(posterior Cobb angle,anterior edge height of injured vertebrae)before and after operation,stress reaction indexes[interleukin-6(IL-6),C-reactive protein(CRP),creatine kinase(CK)]and incidence rate of postoperative complications were compared between two groups.Results The total effective rate in research group was significantly higher than that in control group(P<0.01).After operation for 1 week and at the last follow-up,improvement conditions of posterior Cobb's angle and anterior edge height of injured vertebrae were significantly better in research group than those in control group,and the improvement conditions were more significant with the prolonging therapeutic time in two groups(P<0.05,P<0.01).After operation,levels of IL-6,CRP and CK were significantly higher than those before operation in two groups,but the levels in research group were significantly lower than those in control group(P<0.05,P<0.01).Values of operative duration,intraoperative bleeding volume,wound drainage after operation for 24 h and length of hospitalization in research group were significantly better than those in control group(P<0.01).The total incidence rate of postoperative complications in research group was significantly lower than that in control group(P<0.01).Conclusion Minimally invasive percutaneous pedicle screw fixation in treatment of patients with simple fracture of lumbar vertebra may achieve good clinical efficacy,significantly reduce stress reaction of the bod
作者
李宝元
张晓越
冯伟
刘康
杨维新
LI Bao-yuan;ZHANG Xiao-Yue;FENG Wei;LIU Kang;YANG Wei-xin(Department of Orthopaedics,the People's Hospital of Qingyang City,Qingyang,Gansu 745000,China)
出处
《解放军医药杂志》
CAS
2021年第9期45-49,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
庆阳市科技技术项目(2017Y0027)。
关键词
脊柱骨折
腰椎
经皮椎弓根螺钉内固定
C反应蛋白
肌酸激酶
手术后并发症
Spinal fractures
Lumbar vertebrae
Percutaneous pedicle screw fixation
C-reactive protein
Creatine kinase
Postoperative complications
