早期活动对胸腰椎骨折术后患者影像学疗效的影响

发布时间：2018-02-01 15:48

本文关键词： 胸腰椎骨折早期活动后凸Cobb’s角伤椎椎体前缘高度　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：一、研究目的通过对比早期下床和晚下床的胸腰椎骨折后路内固定术后患者受伤后、术后、术后3个月、术后6个月、术后1年的胸腰椎侧位X线片,探讨早期活动对胸腰椎骨折后路内固定术后患者的椎体高度、矫正角度丢失的影响。二、研究方法通过回顾2011年1月-2013年6月我院收治并行后路内固定的胸腰椎骨折患者63例,按是否早期下床活动分为两组,观察组：术后2周内佩戴腰围下床活动。对照组：术后严格卧床4周以上才佩戴腰围下床活动。测量并对比受伤后、术后、术后3个月、术后6个月、术后1年(未取出内固定物)胸腰椎侧位X线片的伤椎椎体前缘高度、后凸Cobb's角等影像学指标。三、研究结果两组患者术后均达到功能复位要求,且随着时间推移椎体高度、矫正角度都出现了不同程度的丢失,观察组丢失更为明显。术后3个月,矫正角度、椎体高度丢失的幅度最大,术后6个月、术后1年矫正角度、椎体高度的丢失幅度逐渐减小。术后至术后3个月、术后3个月至6个月的伤椎椎体前缘高度、后凸Cobb's角丢失的幅度两组差异有统计学意义(P0.05),术后6个月至术后1年的伤椎椎体前缘高度、后凸Cobb's角丢失的幅度两组差异无统计学意义(P0.05)。四、研究结论早期活动可加重胸腰椎骨折后路内固定术后患者的椎体高度、矫正角度丢失,降低手术疗效。
[Abstract]:Objective: to compare the radiographs of thoracolumbar vertebrae lateral position after injury, 3 months, 6 months and 1 year after thoracolumbar vertebrae fracture in the early stage and late out of bed. To investigate the effect of early movement on the loss of vertebral height and correction angle in patients with thoracolumbar fracture after posterior internal fixation. Methods from January 2011 to June 2013, 63 patients with thoracolumbar vertebrae fracture treated with posterior internal fixation in our hospital were reviewed and divided into two groups according to whether they got out of bed early or not. Observe group: wear waist circumference to get out of bed within 2 weeks after operation. Control group: strictly stay in bed more than 4 weeks before wearing waist circumference to get out of bed. Measure and compare after injury, 3 months after operation, 6 months after operation. 1 year after operation (without internal fixation) the anterior height of the injured vertebral body and the Cobb's angle of the kyphosis of the injured vertebrae on the lateral radiographs of the thoracolumbar vertebrae. 3. The results showed that the functional reduction requirements were achieved in both groups after operation. And with the passage of time, the vertebral height and correction angle were all lost to different degrees, especially in the observation group. 3 months after operation, the loss of vertebral height was the largest, 6 months after operation. 1 year after the correction of the angle, the loss of vertebral height gradually decreased. From postoperative to 3 months, 3 months to 6 months after the injury of the anterior height of the vertebral body. The loss of Cobb's angle of kyphosis was significantly different between the two groups (P 0.05). The height of the anterior edge of injured vertebrae from 6 months to 1 year after operation was significantly different between the two groups. There was no significant difference in the loss of kyphosis Cobb's angle between the two groups (P 0.05). 4. Conclusion early movement can aggravate the vertebral height of patients after posterior internal fixation of thoracolumbar fractures. The loss of correction angle reduces the curative effect of operation.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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