CAJ | 학술논문

目的：探讨后路经椎弓根内固定联合椎体成形术在胸腰段脊柱骨折中的应用价值。方法选择2010年1月至2014年12月铜陵市人民医院诊断为胸腰段脊柱骨折的患者60例作为研究对象,采用随机数字表法平均分为观察组与对照组,各30例。在常规治疗基础上观察组给予后路经椎弓根内固定术治疗联合椎体成形术,对照组给予单独后路经椎弓根内固定术治疗,对手术时间、住院时间、出血量及并发症等进行比较,并比较两组疗效。结果两组患者治疗后脊柱后突Cobb′s角,椎体前缘及后缘高度的压缩率,椎管狭窄率较治疗前显著降低( P <0．05)。观察组术后脊柱后突Cobb′s角,椎体前缘高度压缩率,椎体后缘高度压缩率,椎管狭窄率均显著低于对照组[(4．75±1．73)°比(9．54±0．95)°,(9．74±8．15)%比(15．45±7．24)%,(2．73±1．41)%比(4．94±1．85)%,(7．18±2．86)%比(10．47±3．86)%,P<0．01]。术后观察组神经功能E级比例[76．7%(23/30)]高于对照组[40．0%(12/30)],差异有统计学意义(P<0．05)。结论后路经椎弓根内固定术联合椎体成形术可以更有效改善胸腰椎脊柱骨折的临床体征,提高患者生活质量。
목적：탐토후로경추궁근내고정연합추체성형술재흉요단척주골절중적응용개치。방법선택2010년1월지2014년12월동릉시인민의원진단위흉요단척주골절적환자60례작위연구대상,채용수궤수자표법평균분위관찰조여대조조,각30례。재상규치료기출상관찰조급여후로경추궁근내고정술치료연합추체성형술,대조조급여단독후로경추궁근내고정술치료,대수술시간、주원시간、출혈량급병발증등진행비교,병비교량조료효。결과량조환자치료후척주후돌Cobb′s각,추체전연급후연고도적압축솔,추관협착솔교치료전현저강저( P <0．05)。관찰조술후척주후돌Cobb′s각,추체전연고도압축솔,추체후연고도압축솔,추관협착솔균현저저우대조조[(4．75±1．73)°비(9．54±0．95)°,(9．74±8．15)%비(15．45±7．24)%,(2．73±1．41)%비(4．94±1．85)%,(7．18±2．86)%비(10．47±3．86)%,P<0．01]。술후관찰조신경공능E급비례[76．7%(23/30)]고우대조조[40．0%(12/30)],차이유통계학의의(P<0．05)。결론후로경추궁근내고정술연합추체성형술가이경유효개선흉요추척주골절적림상체정,제고환자생활질량。
Objective To discuss the application value of posterior vertebral pedicle internal fixation and keratoplasty in thoracic lumbar spine fracture. Methods Total of 60 patients diagnosed as thoracic lum-bar spine fracture in Tongling People′s Hospital from Jan. 2010 to Dec. 2014 were included as research objects. All patients were randomly divided into observation group and control group according to random number table method. Patients in the observation group were given posterior vertebral pedicle fixation and ver-tebral plasty,while patients in the control group were given only posterior vertebral pedicle fixation. The oper-ation time,hospitalization time,blood loss and complications were compared. The therapeutic efficacy was followed up for three months. Results The spinal Cobb ′s angle, compression ratio of anterior edge and posterior edge heightand the stenosis rate after treatment were obviously improved compared with before treatment. The differences were statistically significant (P<0. 05). The spinal Cobb′s Angle,compression ratio of anterior edge and posterior edge heightand the stenosis rate in the observation group were signifi-cantly lower than that in the control group[ (4.75 ±1.73)° vs (9.54 ±0.95)°,(9.74 ±8.15)% vs (15. 45 ± 7. 24)%, (2. 73 ± 1. 41)% vs (4. 94 ± 1. 85)%,(7. 18 ± 2. 86)% vs (10. 47 ± 3. 86)%, P<0. 01]. The ratio of nervous function E in the observation group was 76. 7%(23/30),which was high-er than 40. 0%(12/30) in the control group. Conclusion Posterior vertebral pedicle fixation and kerato-plasty can more effectively improve the clinical signs of thoracolumbar spine fracture,and improve the pa-tient quality of life.