摘要
目的:探讨老年中上段胸椎体破裂骨折患者接受单侧通道经皮椎体后凸成形术联合固本益髓灸法的疗效及术后血栓风险的影响。方法:选取2020年1月—2021年12月我院收治的老年中上段胸椎骨折伴锥体后壁破裂患者100例,随机分为对照组和研究组,各50例。对照组接受单侧通道经皮椎体后凸成形术治疗,研究组在此基础上联用固本益髓灸法干预。两组术后均接受骨折护理。比较两组患者的疼痛评分、功能障碍指数,并观察两组患者并发症的发生率,观察并比较患者治疗前后凝血四项指标、D-二聚体、血液流变学指标以及深静脉血栓(DVT)发生情况。结果:治疗18个月后,两组患者的VAS评分和椎体高度均明显低于治疗前(P<0.05)。研究组总并发症发生率明显低于对照组(2%vs 14%,χ^(2)=4.891,P<0.05)。研究组治疗后凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)水平明显优于对照组患者(P<0.05)。研究组治疗后D-二聚体、全血低切黏度、全血高切黏度及血浆黏度水平明显优于对照组患者(P<0.05)。研究组患者治疗7天、治疗14天血栓DVT发生率均明显低于对照组患者(P<0.05)。治疗后,研究组患者的ODI评分显著低于对照组,改良日本骨科学会评分(M-JOA)评分高于对照组(P<0.05)。结论:行单侧通道经皮椎体后凸成形术联合固本益髓灸法治疗中上段胸椎骨折伴锥体后壁破裂患者能达到较好的临床疗效,且术后血栓的发生率也较低。
Objective To investigate the effect of unilateral channel percutaneous kyphoplasty combined with Guben Yisui moxibustion on hidden blood loss and postoperative thrombus risk in elderly patients with middle and upper thoracic vertebra fracture.Methods A total of 100 elderly patients with middle and upper thoracic vertebra fracture with posterior pyramidal wall rupture treated in our hospital from January 2020 to December 2021 were selected and randomly divided into control group and study group,with 50 cases in each group.The control group received unilateral channel percutaneous kyphoplasty treatment,while the research group received intervention with Guben Yisui moxibustion on this basis.Both groups received fracture care after operation.Observe and compare the pain scores and dysfunction indices of two groups of patients,as well as the incidence of complications and safety.Observe the four coagulation indicators,D-dimer indicators,hemorheological indicators,and the occurrence of thrombotic DVT before and after treatment.Results After 18 months of treatment,VAS score,vertebral height in both groups were significantly lower than before treatment(P<0.05).The total complication rate of the study group was significantly lower than that of the control group(2%vs 14%,χ^(2)=4.891,P<0.05).The levels of APTT,PT,TT and FIB in the study group were significantly better than those in the control group after treatment(P<0.05).The levels of D-dimer,whole blood low tangential viscosity,whole blood high tangential viscosity and plasma viscosity in the study group after treatment were significantly better than those in the control group(P<0.05).The incidence of thrombotic DVT in the study group was significantly lower than that in the control group at 7 days and 14 days after treatment(P<0.05).After treatment,the ODI score of the study group was significantly lower than that of the control group,and the M-JOA score was higher than that of the control group(P<0.05).Conclusions Unilateral channel percutaneous kyphoplasty combined
作者
张敏辉
毕若杰
王月
郭志良
张恒
高岩
马姗姗
郭益玮
ZHANG Min-hui;BI Ruo-jie;WANG Yue(Department of Trauma,The Second Hospital of Tangshan,Tangshan(063000),China)
出处
《中国中西医结合外科杂志》
CAS
2024年第3期353-357,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
2022年度河北省医学科学研究课题(20221742)。
关键词
单侧通道经皮椎体后凸成形术
中上段胸椎骨折
椎体后壁破裂
固本益髓灸法
Unilateral channel percutaneous kyphoplasty
fracture of the upper and middle thoracic vertebrae
rupture of the posterior wall of the vertebral body
Guben Yisui moxibustion
