临床外科杂志
臨床外科雜誌
림상외과잡지
JOURNAL OF CLINICAL SURGERY
2014年
8期
595-597,598
,共4页
椎旁肌间隙入路%胸腰椎骨折%内固定
椎徬肌間隙入路%胸腰椎骨摺%內固定
추방기간극입로%흉요추골절%내고정
paraspinal muscle gap approach%thoracolumbar fractures%internal fixation
目的：探讨椎旁肌间隙入路在胸腰椎骨折短节段内固定手术治疗中的临床疗效。方法对45例无需椎管减压的胸腰椎骨折患者行后路短节段内固定治疗，采用椎旁肌间隙入路20例（A组），传统后正中入路25例（B组），分别记录对两组手术时间、术中出血量、术后引流量、术前后疼痛感觉程度评分（VAS）、Cobb 角矫正率、椎体塌陷矫正率指标，分析比较两组的手术效果。结果所有患者骨性愈合，无内固定物松动、断钉断棒；A组与B组的手术时间[（88±17）min vs （105±14）min ]、出血量[（121±24）ml vs （230±31）ml]、术后引流量[（66±28）ml vs （250±45）ml]差异有统计学意义（P＜0．05）；两组在伤椎Cobb角矫正率[（82．3±1．58）％ vs （83．5±3．71）％）]，椎体坍塌矫正率[（88．22±3．18）％vs （87．19±2．16）％]，术后VAS评分等方面差异均无统计学意义（P ＞0．05）。结论椎旁肌间隙入路内固定手术具有创伤小、入路简单、手术时间短、出血量少、术后恢复快等优点，它符合现代微创理念，是值得推广的一种手术入路。
目的：探討椎徬肌間隙入路在胸腰椎骨摺短節段內固定手術治療中的臨床療效。方法對45例無需椎管減壓的胸腰椎骨摺患者行後路短節段內固定治療，採用椎徬肌間隙入路20例（A組），傳統後正中入路25例（B組），分彆記錄對兩組手術時間、術中齣血量、術後引流量、術前後疼痛感覺程度評分（VAS）、Cobb 角矯正率、椎體塌陷矯正率指標，分析比較兩組的手術效果。結果所有患者骨性愈閤，無內固定物鬆動、斷釘斷棒；A組與B組的手術時間[（88±17）min vs （105±14）min ]、齣血量[（121±24）ml vs （230±31）ml]、術後引流量[（66±28）ml vs （250±45）ml]差異有統計學意義（P＜0．05）；兩組在傷椎Cobb角矯正率[（82．3±1．58）％ vs （83．5±3．71）％）]，椎體坍塌矯正率[（88．22±3．18）％vs （87．19±2．16）％]，術後VAS評分等方麵差異均無統計學意義（P ＞0．05）。結論椎徬肌間隙入路內固定手術具有創傷小、入路簡單、手術時間短、齣血量少、術後恢複快等優點，它符閤現代微創理唸，是值得推廣的一種手術入路。
목적：탐토추방기간극입로재흉요추골절단절단내고정수술치료중적림상료효。방법대45례무수추관감압적흉요추골절환자행후로단절단내고정치료，채용추방기간극입로20례（A조），전통후정중입로25례（B조），분별기록대량조수술시간、술중출혈량、술후인류량、술전후동통감각정도평분（VAS）、Cobb 각교정솔、추체탑함교정솔지표，분석비교량조적수술효과。결과소유환자골성유합，무내고정물송동、단정단봉；A조여B조적수술시간[（88±17）min vs （105±14）min ]、출혈량[（121±24）ml vs （230±31）ml]、술후인류량[（66±28）ml vs （250±45）ml]차이유통계학의의（P＜0．05）；량조재상추Cobb각교정솔[（82．3±1．58）％ vs （83．5±3．71）％）]，추체담탑교정솔[（88．22±3．18）％vs （87．19±2．16）％]，술후VAS평분등방면차이균무통계학의의（P ＞0．05）。결론추방기간극입로내고정수술구유창상소、입로간단、수술시간단、출혈량소、술후회복쾌등우점，타부합현대미창이념，시치득추엄적일충수술입로。
Objective To investigate the clinical efficacy of paraspinal muscle gap approach in the short segment internal fixation of thoracolumbar fractures.Methods Forty-five patients with thoraco-lumbar fractures but without spinal decompression underwent posterior short segment internal fixation,in-cluding 20 cases via paraspinal muscle gap approach(group A)and 25 cases via traditional posterior mid-line approach.Operative time,intraoperative blood loss,postoperative drainage,visual analogue scale (VAS)score,correction rate of Cobb angle and correction rate of vertebral collapse were recorded and the surgical results were compared between the groups.Results All patients got bony union without internal fixation loosening,broken nails or broken rods.There were significant differences in operative time [(88 ± 17)min vs(105 ±14)min],blood loss [(121 ±24)ml vs(230 ±31 )ml]and postoperative drainage [(66 ±28)ml vs(250 ±45)ml]between group A and B respectively(P<0.05).The differences in cor-rection rate of the Cobb angle [(82.3 ±1.58)% vs(83.5 ±3.71)%],correction rate of the vertebral collapse [(88.22 ±3.18)%vs(87.19 ±2.16)%]and postoperative VAS score were not significant be-tween group A and B respectively(P>0.05 ).Conclusion Internal fixation via paraspinal muscle gap approach has the advantages of less trauma,simple approach,short operative time,less blood loss,quick recovery after surgery.It is consistent with the modern concept of minimal invasion and worthy of sprea-ding.
