摘要
目的 探讨微创小切口普通椎弓根螺钉固定治疗对胸腰椎骨折患者血清肌酸激酶(CK)、高迁移率族蚩白B-1(HMGB-1)及肿瘤坏死因子-α(TNF-α)水平的影响。方法 对2022年2月至2023年2月期间厦门大学附属成功医院收治的124例胸腰椎骨折患者行回顾性研究,按照手术方案不同分为对照组(n=60,切开椎弓根螺钉内固定治疗)与试验组(n=64,微创小切口普通椎弓根螺钉固定治疗)。比较两组患者围手术期指标、治疗前后炎性因子[CK、HMGB-1及TNF-α]变化、 Oswestry功能障碍指数问卷(ODI)、视觉模拟评分法(VAS)评分及术后并发症情况。结果 与对照组比较,试验组手术总时长、透视时间、术中出血量、术后住院天数及骨折愈合时长更短,术中出血量更少,差异有统计学意义(P<0.05);治疗后1 d、3 d,两组CK、HMGB-1及TNF-α水平均明显上升,治疗7 d出现下降,且试验组上述指标水平低于对照组,差异有统计学意义(P<0.05);治疗后6个月,两组ODI评分、VAS评分均明显降低,且试验组上述评分均低于对照组,差异有统计学意义(P<0.05);试验组的并发症率(3.12%)比对照组(15.00%)低,差异有统计学意义(P<0.05)。结论 微创小切口普通椎弓根螺钉固定治疗可显著降低胸腰椎骨折患者CK、HMGB-1及TNF-α水平,促进患者术后恢复速度。
Objective To investigate the effects of minimally invasive small incision common pedicle screw fixation on serum creatine kinase(CK),high mobility group protein-1(HMGB-1)and tumor ne-crosis factor-α(TNF-α)levels in patients with thoracolumbar spine fractures.(TNF-α)levels.Methods Thora-columbar spine fracture patients admitted to Success Hospital of Xiamen University from February 2022 to Feb-ruary 2023 were retrospectively screened.After careful evaluation,144 patients were finally selected,20 cases were excluded,and 124 cases were finally included.The group was divided into a control group(n=60,inci-sion pedicle screw internal fixation treatment)and an experimental group(n=64,minimally invasive small-inci-sion plain pedicle screw fixation treatment)based on the surgical protocol.A comparison of perioperative indi-ces,changes in inflammatory factors[CK,HMGB-1 and TNF-α]before and after treatment,Oswestry dys-function index questionnaire(ODI),Visual Analogue Scale(VAS)scores and postoperative complications were compared between the two groups,VAS scores and postoperative complications.Results Compared to the control group,the experimental group had shorter total operation time,fluoroscopy time,intraoperative hemorrhage,postoperative hospital days and fracture healing time,and less intraoperative hemorrhage,with statistically significant differences(P<0.05).After 1 day and 3 days of treatment,the levels of CK,HMGB-1,and TNF-αincreased significantly in both groups,and decreased in 7 days of treatment,and the levels of these in-dicators in the experimental group were lower than those in the control group,and the difference was statistically significant(P<0.05).Six months after treatment,the ODI scores and VAS scores of both groups were signifi-cantly reduced,and the above scores of the experimental group were lower than those of the control group,and the difference was statistically significant(P<0.05).The complication rate was lower in the test group(3.12%)compared to the control group(15.00%),and the differen
作者
谢德胜
简国坚
陈小林
王博文
刘好源
XIE Desheng;JIAN Guojian;CHEN Xiaolin;WANG Bowen;LIU Haoyuan(Department of Orthopedics,Chengong Hospital affiliated to Xiamen University(The 73th Group Military Hospital of People's Liberation Army),Xiamen,Fujian,China,361000)
出处
《分子诊断与治疗杂志》
2024年第6期1028-1031,共4页
Journal of Molecular Diagnostics and Therapy
基金
厦门市创伤骨科重点专科建设项目(2015347)。
