摘要
目的 探讨经皮微创与开放手术治疗胸腰椎骨折的疗效及安全性。方法 2018年4月~2022年4月本院接受手术干预治疗的胸腰椎骨折病人62例,采用随机数字表法分为经皮微创入路组及传统开放组,每组均31例。传统开放组病人予以开放手术即传统开放内固定手术,经皮微创入路组病人予以经皮经微创入路手术治疗。对比两组病人手术用时、切口长度、术中出血量、住院时间等手术相关指标,观察两组病人术后1天、术后3天、术后7天的视觉模拟量表(VAS)评分变化情况,比较两组病人手术前后血沉(ESR)、D二聚体(D-D)因子指标水平变化情况、手术前后椎间隙高度、后凸Cobb角影像学相关指标情况以及术后并发症总发生率。结果 经皮微创入路组手术用时(65.25±13.76)分钟、切口长度(8.31±1.44)cm、术中出血量(91.37±11.09)ml、住院时间(8.59±1.35)天,均低于传统开放组(110.37±20.43)分钟、(13.17±2.02)cm、(475.38±18.36)ml、(11.93±2.91)天,差异有统计学意义(P<0.05);两组病人术后VAS评分均随着时间的延长而逐渐降低,但经皮微创入路组术后1天(7.12±1.13)、术后3天(3.27±0.75)、术后7天(2.47±0.78) VAS评分均低于传统开放组(8.36±1.64、5.48±1.27、4.26±1.36),差异有统计学意义(P<0.5);术后3天两组ESR、D-D水平较手术前均升高,但经皮微创入路组各指标水平均明显低于传统开放组,差异有统计学意义(P<0.05);术后7天经皮微创入路组病人术后同一时间段椎间隙高度(92.66±5.72 vs 83.17±5.04)、后凸Cobb角(7.37±2.85 vs 9.72±3.18)均明显优于传统开放组,差异有统计学意义(P<0.05);经皮微创入路组并发症总发生率低于传统开放组(6.45%vs 35.48%),差异有统计学意(P<0.05)。结论 经皮微创入路术式可促进病人术后快速恢复,减轻疼痛,降低术后并发症发生风险。
Objective To compare the clinical effect of percutaneous minimally invasive surgery with open surgery for lumbar fracture.Methods A total of 62 patients with thoracolumbar fracture who received surgical intervention in our hospital from April 2018 to April 2022 were selected and divided into percutaneous minimally invasive approach group and traditional open group according to random number table method,with 31 cases in each group.Patients in the traditional open group were treated with open surgery,that is,traditional open internal fixation,and patients in the percutaneous minimally invasive approach group were treated with minimally invasive percutaneous approach.Surgical indexes such as operation time,incision length,intraoperative blood loss,length of hospital stay and so on were compared between the two groups.Visual Analog Scale(VAS)scores of the two groups were observed 1,3 and 7 days after surgery.Changes in ESR and D-dimer factor indexes before and after surgery were compared between the two groups.The vertebral space height,kyphotic Cobb Angle imaging indicators before and after surgery were compared between the two groups,and the total incidence of postoperative complications was compared between the two groups.Results The surgical time,incision length,intraoperative bleeding volume,and hospital stays of the minimally invasive percutaneous approach group were(65.25±13.76)minutes,(8.31±1.44)cm,(91.37±11.09)ml and(8.59±1.35)d,respectively,which were significantly lower than those of the traditional open group[(110.37±20.43)minutes,(13.17±2.02)cm,(475.38±18.36)ml,and(11.93±2.91)d](all P<0.05).The postoperative VAS scores of both groups of patients gradually decreased with time(P<0.05),but the VAS scores of the percutaneous minimally invasive approach group on the 1st day(7.12±1.13),3rd day(3.27±0.75),and 7th day(2.47±0.78)after surgery were significantly lower than those of the traditional open group(8.36±1.64,5.48±1.27,4.26±1.36)(all P<0.05).Three days after surgery,two groups of serum fact
作者
胡家瑞
宋明
余来
HU Jiarui;SONG Ming;YU Lai(Department of Orthopedics,Xiamen Changgeng Hospital,Xiamen 361028,China)
出处
《临床外科杂志》
2023年第9期881-884,共4页
Journal of Clinical Surgery
关键词
经皮微创入路手术
开放手术
腰椎骨折
临床疗效
percutaneous minimally invasive approach
open surgery
lumbar spine fracture
clinical efficacy
