经椎旁肌入路与传统后正中入路治疗胸腰椎骨折的效果观察.docVIP

经椎旁肌入路与传统后正中入路治疗胸腰椎骨折的效果观察 　　[摘要] 目的 比较经椎旁肌入路与传统后正中入路治疗胸腰椎骨折的临床效果，探讨胸腰椎骨折内固定手术的最佳显露方式。 方法 选取2011年6月～2014年6月在本院就诊的62例胸腰椎骨折患者，将其随机分为治疗组（24例）与对照组（38例）。治疗组采用经椎旁肌间隙入路治疗，对照组采用传统后正中入路治疗。从Cobb角矫正率、手术时间、术中出血量、术后疼痛感觉程度等方面观察两组的疗效。 结果 术后及未次随访显示，两组Cobb角均较术前显著改善（P0.05）。两组术前、术后及末次随访的Cobb角比较，组间差异无统计学意义（P0.05）。治疗组的手术时间短于对照组，术中出血量少于对照组，腰背肌锻炼时间及下床活动时间早于对照组，差异有统计学意义（P0.05）。治疗组术后1周及术后1个月的VAS评分高于对照组，差异有统计学意义（P0.05）。 结论 经椎旁肌间隙入路固定治疗胸腰段椎骨折，具有创伤小、出血少、术中操作简单、术后患者恢复快等优点。 　　[关键词] 胸腰椎骨折；椎旁肌入路；传统后正中入路 　　[中图分类号] R683.2 [文献标识码] A [文章编号] 1674-4721（2016）02（a）-0085-04 　　Effect observation of paraspinal muscle approach and traditional posterior median approach in the treatment of thoracolumbar fractures 　　YUAN Xian-yun WU Jun LIU Wei LAI Wei-wen 　　Spinal Surgery，People′s Hospital of Yudu County in Jiangxi Province，Yudu 342300，China 　　[Abstract] Objective To compare the clinical effect of paraspinal muscle approach and traditional posterior median approach in the treatment of thoracolumbar fracture，and to explore the best exposure model of thoracolumbar fracture internal fixation surgery. Methods 62 patients with thoracolumbar fracture reated in our hospital from June 2011 to June 2014 were selected and randomly divided into the treatment group（24 cases） and the control group（38 cases）.The treatment group was used paraspinal muscle approach，the control group was used traditional posterior median approach.The curative effect in two groups was observed，such as aspects of Cobb angle correction rate，operation time，bleeding volume and postoperative pain sensation degree and so on. Results Compared with before operation，the Cobb angle in two groups was significantly improved after operation and last follow-up（P0.05）.The operation time in treatment group was shorter than the control group，bleeding volume in treatment group was less than the control group，and back muscle exercise time，get out of bed activity time was earlier than the control group，the difference was significant（P0.05）.1 week and 1 m