CAJ | 학술논문

目的：比较前路椎体次全切除减压内固定与后路椎体次全切除减压内固定治疗胸腰椎爆裂性骨折患者的临床效果。方法选择于2012年3月~2013年3月在青海省人民医院治疗的胸腰椎爆裂性骨折患者170例，根据手术方式的不同分为A组与B组，A组80例，行前路椎体次全切除并采用钛网内固定术，B组90例，行后路椎体次全切除并采用钛网内固定，比较两组手术临床效果及神经功能分级。结果①两组患者一般手术指标如手术时间、出血量等比较差异无统计学意义(P>0.05)；②治疗后，两组患者的VAS评分均有所改善，但B组评分[(2.20±0.24)分]显著低于A组[(3.31±0.55)分]，差异有统计学意义(P<0.05)；③术后1年复查显示，B组Cobb角[(6.46±0.85)o]明显大于A组[(5.82±0.72)o]，差异有统计学意义(P<0.05)。结论经后路椎体次全切除减压内固定手术较前路椎体次全切除减压内固定手术能更有效减轻胸腰椎爆裂性骨折患者术后的痛苦，对术后肺功能影响小，是相对安全有效的手术方式。
목적：비교전로추체차전절제감압내고정여후로추체차전절제감압내고정치료흉요추폭렬성골절환자적림상효과。방법선택우2012년3월~2013년3월재청해성인민의원치료적흉요추폭렬성골절환자170례，근거수술방식적불동분위A조여B조，A조80례，행전로추체차전절제병채용태망내고정술，B조90례，행후로추체차전절제병채용태망내고정，비교량조수술림상효과급신경공능분급。결과①량조환자일반수술지표여수술시간、출혈량등비교차이무통계학의의(P>0.05)；②치료후，량조환자적VAS평분균유소개선，단B조평분[(2.20±0.24)분]현저저우A조[(3.31±0.55)분]，차이유통계학의의(P<0.05)；③술후1년복사현시，B조Cobb각[(6.46±0.85)o]명현대우A조[(5.82±0.72)o]，차이유통계학의의(P<0.05)。결론경후로추체차전절제감압내고정수술교전로추체차전절제감압내고정수술능경유효감경흉요추폭렬성골절환자술후적통고，대술후폐공능영향소，시상대안전유효적수술방식。
Objective To investigate the clinical effect of anterior corpectomy combined with internal fixation and pos-terior corpectomy combined with internal fixation in the treatment of patients with thoracolumbar burst fracture. Meth-ods 170 cases of patients with thoracolumbar burst fracture in Qinghai People's Hospital from March 2012 to March 2013 were selected, they were divided into two groups according to the surgical procedures: group A and group B, group A of 80 cases, group B of 90 cases. Group A was treated with anterior corpectomy combined with internal fixa-tion, group B was treated with posterior corpectomy combined with internal fixation, two groups of clinical efficacy and nerve function grading were compared. Results ①Two groups of patient's general operation parameters such as opera-tion time, bleeding volume had no significant differences (P > 0.05); ②after treatment, two groups of patient's VAS scores were improved, but the score in group B [(2.20±0.24) points] was significantly lower than that of group A [(3.31±0.55) points], the difference was statistically significant (P<0.05);③the review after 1 year showed that the Cobb an-gle of group B [(6.46±0.85)o] was significantly greater than that of group A [(5.82±0.72)o], the difference was statistical-ly significant (P<0.05). Conclusion Comparing posterior corpectomy surgery to anterior corpectomy surgery, the pos-terior corpectomy surgery can effectively relieve the postoperative suffering of patients with thoracolumbar burst frac-ture, it's less impact on the postoperative pulmonary function, and it's a relatively safe and effective operation method.