中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
6期
862-864
,共3页
杨明智%张建华%刘志斌%高新星%宗龙泽
楊明智%張建華%劉誌斌%高新星%宗龍澤
양명지%장건화%류지빈%고신성%종룡택
胸腰椎骨折%胸腰椎损伤分类及损伤程度评分系统%指导意义
胸腰椎骨摺%胸腰椎損傷分類及損傷程度評分繫統%指導意義
흉요추골절%흉요추손상분류급손상정도평분계통%지도의의
Thoracolumbar fractures%Thoracolumbar injury classification and injury severity score%Guidance significance
目的 探讨胸腰椎损伤分类及损伤程度评分系统(TLICS)对临床治疗胸腰椎骨折的指导作用.方法 收集2011年7月至2012年7月延安大学附属医院骨科94例胸腰椎骨折患者的病历资料进行回顾性分析.TLICS评分≤3分者采用保守治疗;TLICS评分＝4分者,则根据患者的年龄、病情、有无神经症状及全身综合情况决定治疗方案;评分≥5分者选择手术治疗.随访至治疗后6个月,评价治疗后功能改善率、椎前高度和Cobb角变化、脊髓神经功能情况.结果 TLICS评分≤3分者16例,全部采用保守治疗;TLICS评分＝4分者10例,其中4例保守治疗,6例手术治疗;TLICS评分≥5分者68例,选择手术治疗.保守治疗和手术治疗者优良率分别为90.0％ (18/20)、89.2％(66/74),差异无统计学意义(P＞0.05).2种治疗方式治疗后6个月椎前高度、Cobb角均较治疗前明显改善,差异有统计学意义[保守治疗前后椎前高度:(51 ± 16)％、(91 ±4)％,Cobb角:(31.4 ±4.3)°、(4.2 ± 1.4)°;手术治疗前后椎前高度:(52 ±16)％、(94 ±6)％,Cobb角:(33.6 ±3.8)°、(3.2 ± 1.2)°](均P＜0.05).脊髓神经功能都有不同程度恢复.结论 TLICS评分系统对胸腰椎骨折的治疗具有重要指导意义.
目的 探討胸腰椎損傷分類及損傷程度評分繫統(TLICS)對臨床治療胸腰椎骨摺的指導作用.方法 收集2011年7月至2012年7月延安大學附屬醫院骨科94例胸腰椎骨摺患者的病歷資料進行迴顧性分析.TLICS評分≤3分者採用保守治療;TLICS評分＝4分者,則根據患者的年齡、病情、有無神經癥狀及全身綜閤情況決定治療方案;評分≥5分者選擇手術治療.隨訪至治療後6箇月,評價治療後功能改善率、椎前高度和Cobb角變化、脊髓神經功能情況.結果 TLICS評分≤3分者16例,全部採用保守治療;TLICS評分＝4分者10例,其中4例保守治療,6例手術治療;TLICS評分≥5分者68例,選擇手術治療.保守治療和手術治療者優良率分彆為90.0％ (18/20)、89.2％(66/74),差異無統計學意義(P＞0.05).2種治療方式治療後6箇月椎前高度、Cobb角均較治療前明顯改善,差異有統計學意義[保守治療前後椎前高度:(51 ± 16)％、(91 ±4)％,Cobb角:(31.4 ±4.3)°、(4.2 ± 1.4)°;手術治療前後椎前高度:(52 ±16)％、(94 ±6)％,Cobb角:(33.6 ±3.8)°、(3.2 ± 1.2)°](均P＜0.05).脊髓神經功能都有不同程度恢複.結論 TLICS評分繫統對胸腰椎骨摺的治療具有重要指導意義.
목적 탐토흉요추손상분류급손상정도평분계통(TLICS)대림상치료흉요추골절적지도작용.방법 수집2011년7월지2012년7월연안대학부속의원골과94례흉요추골절환자적병력자료진행회고성분석.TLICS평분≤3분자채용보수치료;TLICS평분＝4분자,칙근거환자적년령、병정、유무신경증상급전신종합정황결정치료방안;평분≥5분자선택수술치료.수방지치료후6개월,평개치료후공능개선솔、추전고도화Cobb각변화、척수신경공능정황.결과 TLICS평분≤3분자16례,전부채용보수치료;TLICS평분＝4분자10례,기중4례보수치료,6례수술치료;TLICS평분≥5분자68례,선택수술치료.보수치료화수술치료자우량솔분별위90.0％ (18/20)、89.2％(66/74),차이무통계학의의(P＞0.05).2충치료방식치료후6개월추전고도、Cobb각균교치료전명현개선,차이유통계학의의[보수치료전후추전고도:(51 ± 16)％、(91 ±4)％,Cobb각:(31.4 ±4.3)°、(4.2 ± 1.4)°;수술치료전후추전고도:(52 ±16)％、(94 ±6)％,Cobb각:(33.6 ±3.8)°、(3.2 ± 1.2)°](균P＜0.05).척수신경공능도유불동정도회복.결론 TLICS평분계통대흉요추골절적치료구유중요지도의의.
Objective To investigate the clinical guidance of thoracolumbar injury classification and injury severity score (TLICS) for the treatment of thoracolumbar fractures.Methods Totally 94 cases of thoracolumbar fractures patients were treated.Conventional X-ray,CT and MRI were performed after admission.According to the TLICS,conservative treatment was performed in patients TLICS ≤3; operation was applied in patients TLICS ≥5 ; the treatment of patients(TLICS =4) was decided on the disease status.Follow-up was six months and the curative effect before and after treatment was compared.Oswestry disability index (ODI) was used to evaluate the functional improvement rate ; the improvement of vertebral height and cobb angle before and after treatment was observed by X-ray and CT examination ; the recovery of spinal cord function was analyzed by ASIS.Results After treatment,both 20 patients with conservative treatment and 74 patients with surgery had an obvious improvement of dysfunction (P ＞ 0.05).After treatment,the vertebral height and cobb angle had significant differences[conservative treatment:(91 ± 4) ％ vs (51 ± 16) ％,(4.2 ± 1.4) ° vs (31.4 ± 4.3) ° ; operation treatment:(94 ± 6) ％vs (52 ± 16) ％,(3.2 ± 1.2) ° vs (33.6 ± 3.8) °,P ＜ 0.05].Spinal cord function had a different degree of recovery.Conclusion TLICS system has an important guiding significance in the treatment of thoraeolumbar fractures.
