椎弓根钉治疗胸腰椎骨折例疗效观察.docVIP

椎弓根钉治疗胸腰椎骨折52例疗效观察 【摘要】目的 探讨椎弓根钉治疗胸腰椎骨折的临床效果。方法 选取2011年3月～2013年3月来我院治疗胸腰椎骨折的52例患者，随机分成两组，即普通椎钉固定组(对照组)和椎弓根钉固定组（治疗组），每组26例。比较患者治疗前后的椎体变化程度和神经系统等方面康复情况。结果 术前两组的椎体前椎体横截面、后缘平均高度均无显著差别，经过手术治疗后两组患者三组参数指标均差异显著，具有统计学意义（P0.05）。结论 椎弓根钉在治疗胸腰椎骨折方面安全有效，具有复位理想、术后并发症少等特点，值得在临床上推广应用。 【关键词】椎弓根钉；胸腰椎骨折；疗效观察 [Abstract]Objective To investigate the method of pedicle screw for treatment of thoracolumbar fractures clinical effect. Methods 52 cases of 2011 March to 2013 March in our hospital for treatment of thoracolumbar fracture were analysed, and the 76 cases of patients were randomly divided into two groups and were namely normal vertebral fixation group (control group) and pedicle screw fixation group (treatment group), each group was 26 cases. To compare the rehabilitation of patients that the degree of vertebral changes before and after treatment and nervous system. Results The vertebral cross-sectional area and trailing average height of the two groups before treatment were no significant difference .But three groups of parameters of two groups were significantly different after treatment, after operation,and had statistical significance (P0.05). Conclusion Through the observation of clinical treatment of 2 groups of patients, the pedicle screw is safe and effective. It has the characteristics of good of healing effect, less postoperative complications and so on, which is worthy of further application in clinical practice. [keyword] pedicle screw; thoracolumbar fracture; curative effect observation 胸腰椎骨折是由外力对胸腰椎骨质所造成的连续性破坏，约占总创伤骨折的3%～5%［1］。为了寻找安全有效的治疗途径，本文选取2011年3月～2013年3月间来我院就诊的52例胸腰椎骨折患者作为研究对象，采用两种不同的实验方案进行治疗研究，报道如下。 材料与实验方法 1.1应用资料 资料来源于2011年3月～2013年3月来我院就诊的52例胸腰椎骨折的患者，年龄18～56岁，平均（30.5±10.5）岁。随机分成两组，即椎弓根螺钉固定组(对照组)和椎弓根钉棒系统固定组（治疗组），每组26例。两组患者性别、年龄等一般资料差异无统计学意义(P＞0.05)，具有可比性。 1.2治疗方法 椎弓根钉固定组：①取俯卧位，在全麻下进行，铺无菌单。在棘突旁注射200m含有0.1mg肾上腺素的等渗生理盐水，处理好合并脑损伤、脏器损伤等并发症后进行手术。③术中，以损伤的脊椎为中心，行一切口，约12～14cm，剥离椎管旁的肌肉直到关节突的外缘部位，充分露出棘突、椎板和横突以及关节突。选择上关节突外缘的垂直延长线与固定椎横突的中轴线水平交汇处，为了确保钻尖准确性，可预先去除点旁骨皮质，再进行钻孔