经皮与开放椎弓根螺钉内固定术治疗胸腰椎骨折围手术期炎性状态变化的临床观察
发布时间：2018-10-21 15:44
【摘要】：目的探讨经皮与开放椎弓根螺钉内固定术,治疗胸腰椎新鲜骨折围手术期的炎性状态变化的差异。方法选取2014年01月至2015年01月广州军区武汉总医院骨科脊柱病区收治的40例符合本研究设定的纳入标准的患者的临床数据进行分析所选病例符合椎管占位≤椎管矢状径1/3,不伴神经症状,无需椎管减压。所有病例术前均采用AO Margerl分型,随机分两组,半数行经皮椎弓根螺钉内固定术(经皮组),半数行传统后路开放椎弓根螺钉内固定术(开放组),均为跨伤椎的4钉固定。分别记录两组患者的围手术期炎性指标数据,包括：术前(骨折后48h内)、术后1d、4d、7d的血清肌酸激酶以及术前、术后(24-48h内拔除引流管后)MRI检查所显示的炎性水肿区域的体积。结果对比两组患者一般资料及Cobb角、椎体前缘高度,差异无统计学意义(P0.05),具备可比性。观察并比较经皮组和开放组术前(骨折后48h内)、术后1d、4d、7d的血清肌酸激酶的检测结果,术前经皮组与开放组检测结果接近(P0.05),无明显差异,术后1d、4d、7d的血清肌酸激酶开放组均明显高于经皮组(P0.05),有显著性差异。观察并比较经皮组和开放组术前、术后MRI所显示的炎性水肿区域的体积的大小,术前经皮组与开放组结果接近(P0.05),无明显差异,术后开放组明显高于经皮组(P0.05),有显著性差异。结论微创经皮螺钉内固定术对软组织的损伤程度及造成的局部炎症反应均轻于传统开放椎弓根螺钉内固定术,术后恢复也更快,值得临床推广。
[Abstract]:Objective to investigate the difference of perioperative inflammatory state between percutaneous and open pedicle screw fixation in the treatment of fresh thoracolumbar fractures. Methods from January 2014 to January 2015, the clinical data of 40 patients in the Department of Orthopaedics, Wuhan General Hospital of Guangzhou military region from January 2014 to January 2015 were selected and analyzed. Sagittal diameter 1 / 3, without neurological symptoms, There is no need for decompression of the spinal canal. All patients were divided into two groups randomly according to AO Margerl classification before operation. Half of them were treated with percutaneous pedicle screw fixation (percutaneous group) and half with traditional posterior open pedicle screw fixation (open group). The perioperative inflammatory index data of the two groups were recorded, including preoperative (within 48 hours after fracture), serum creatine kinase (creatine kinase) at 1 day and 4 days after operation, and volume of inflammatory edema area in preoperative and postoperative (24-48 hours after extubation) MRI examination. Results there was no significant difference between the two groups in general data, Cobb angle, anterior height of vertebral body (P0.05). The results of serum creatine kinase were observed and compared between the percutaneous group and the open group before operation (within 48 hours after fracture) and 1 day after operation. The results of serum creatine kinase in the percutaneous group were similar to those in the open group (P0.05), and there was no significant difference between the preoperative group and the open group (P0.05). The serum creatine kinase opening group was significantly higher than that of the transcutaneous group (P0.05) on the 1st and 4th day after operation (P0.05). The volume of inflammatory edema area showed by MRI before operation and open group was observed and compared. The results of preoperative percutaneous group and open group were similar (P0.05), but the postoperative open group was significantly higher than that of percutaneous group (P0.05). Conclusion the degree of soft tissue injury and the local inflammatory reaction caused by minimally invasive percutaneous screw fixation are lighter than those of traditional open pedicle screw fixation, and the postoperative recovery is faster, which is worth popularizing.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2285578
[Abstract]:Objective to investigate the difference of perioperative inflammatory state between percutaneous and open pedicle screw fixation in the treatment of fresh thoracolumbar fractures. Methods from January 2014 to January 2015, the clinical data of 40 patients in the Department of Orthopaedics, Wuhan General Hospital of Guangzhou military region from January 2014 to January 2015 were selected and analyzed. Sagittal diameter 1 / 3, without neurological symptoms, There is no need for decompression of the spinal canal. All patients were divided into two groups randomly according to AO Margerl classification before operation. Half of them were treated with percutaneous pedicle screw fixation (percutaneous group) and half with traditional posterior open pedicle screw fixation (open group). The perioperative inflammatory index data of the two groups were recorded, including preoperative (within 48 hours after fracture), serum creatine kinase (creatine kinase) at 1 day and 4 days after operation, and volume of inflammatory edema area in preoperative and postoperative (24-48 hours after extubation) MRI examination. Results there was no significant difference between the two groups in general data, Cobb angle, anterior height of vertebral body (P0.05). The results of serum creatine kinase were observed and compared between the percutaneous group and the open group before operation (within 48 hours after fracture) and 1 day after operation. The results of serum creatine kinase in the percutaneous group were similar to those in the open group (P0.05), and there was no significant difference between the preoperative group and the open group (P0.05). The serum creatine kinase opening group was significantly higher than that of the transcutaneous group (P0.05) on the 1st and 4th day after operation (P0.05). The volume of inflammatory edema area showed by MRI before operation and open group was observed and compared. The results of preoperative percutaneous group and open group were similar (P0.05), but the postoperative open group was significantly higher than that of percutaneous group (P0.05). Conclusion the degree of soft tissue injury and the local inflammatory reaction caused by minimally invasive percutaneous screw fixation are lighter than those of traditional open pedicle screw fixation, and the postoperative recovery is faster, which is worth popularizing.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
【参考文献】
相关期刊论文 前1条
1 李展新;;活血化瘀中药煎汤内服外洗对骨折患者康复效果观察[J];现代诊断与治疗;2014年05期
，本文编号：2285578
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