前后路手术治疗胸腰段脊柱骨折的疗效对比

发布时间：2018-03-15 08:16

  本文选题：胸腰段　切入点：脊柱骨折　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：比较前路与后路手术治疗胸腰段脊柱骨折的疗效。方法：回顾性分析兰州军区乌鲁木齐总医院2009年1月-2012年1月73例胸腰段脊柱骨折的患者,其中后路手术42例(A组),前路手术31例(B组)。查阅病例及相关资料记录两组患者的年龄、性别、致伤原因、是否合并有慢性疾病、手术时间、术中出血量及两组患者手术前后触觉评分、运动评分、cobb's角、伤椎高度、脊髓功能分级,术后并发症、术后患者有效率等数据资料。结果：1.两组术前ASIA分级、触觉评分、运动评分、cobb's角、伤椎高度比较无差异(P0.05)；2.两组手术时间及术中出血量比较有明显差异(P0.05),A组优于B组；3.两组术后触觉评分、运动评分、cobb's角、伤椎高度比较,有统计学差异(P0.05),B组优于A组；4.两组术后触觉评分、运动评分、cobb's角、伤椎高度均较术前有统计学差异(P0.05),两组术后较术前均有明显改善；5.两组病例疗效比较,显效与无效两组之间比较无差异(P0.05),有效两组之间比较有差异(P0.05),总有效率两组无差异(P0.05)。结论：成人胸腰段脊柱骨折,前后路手术入路均有效,总有效率无明显差异。后路手术入路操作相对简单,手术时间短、出血量少,而前路手术入路操作复杂,术中出血量多,但其脊髓神经功能恢复相对较好,更有利于恢复脊柱稳定性,值得临床推广。
[Abstract]:Objective: to compare the effects of anterior and posterior approaches in the treatment of thoracolumbar spinal fractures. Methods: 73 patients with thoracolumbar spinal fractures from January 2009 to January 2012 in Urumqi General Hospital of Lanzhou military region were retrospectively analyzed. Among them, 42 cases were treated by posterior approach and 31 cases by anterior approach. The age, sex, cause of injury, chronic disease, time of operation were recorded by consulting the cases and related data. Data of intraoperative bleeding volume and tactile score before and after operation, motor score, spinal height, spinal functional grading, postoperative complications, effective rate of postoperative patients were obtained. Results: 1. ASIA grade and tactile score before operation, tactile score, and so on. There was no significant difference between the two groups in the operation time and the amount of blood lost during operation. Group A was better than group B in terms of tactile score, motor score, angle of cobbbbus, height of injured vertebrae, postoperative tactile score, motor score, and height of injured vertebrae. The scores of tactile sensation, motor score and height of injured vertebrae in group B were better than those in group A (P 0.05), and there were significant differences between the two groups after operation (P < 0.05). The curative effect of two groups was significantly improved after operation than that before operation (P 0.05), and there was no significant difference between the two groups in terms of postoperative tactile score, motor score and the height of injured vertebrae (P 0.05). There was no difference between the two groups (P 0.05). The total effective rate was not different between the two groups. Conclusion: the thoracolumbar spine fracture in adults, the anterior and posterior approaches are all effective. There was no significant difference in the total effective rate. The operation of posterior approach was relatively simple, the operation time was short, the amount of bleeding was less, but the operation of anterior approach was complicated and the amount of intraoperative bleeding was much, but the neurological function of spinal cord recovered relatively well. More conducive to the restoration of spinal stability, worthy of clinical promotion.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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本文编号：1615183