| 毛洪刚,朱艳丽,刘国栋,刘 岩,冉 博.伤椎置钉与不置钉短节段内固定对胸腰椎爆裂骨折患者临床疗效及血清炎症损伤介质的影响[J].,2020,(2):324-328 |
| 伤椎置钉与不置钉短节段内固定对胸腰椎爆裂骨折患者临床疗效及血清炎症损伤介质的影响 |
| Effect of Short-segment Internal Fixation with or without Screw Placement in Injured Vertebra on Clinical Efficacy and Serum Inflammatory Injury Mediators in Patients with Thoracolumbar Burst Fracture |
| 投稿时间：2019-07-18 修订日期：2019-08-13 |
| DOI：10.13241/j.cnki.pmb.2020.02.025 |
| 中文关键词: 伤椎置钉 伤椎不置钉 短节段内固定 胸腰椎爆裂骨折 临床疗效 炎症 |
| 英文关键词: Screw placement in injured vertebra Without screw placement in injured vertebra Short-segment internal fixation Thoracolumbar burst fracture Clinical efficacy Inflammation |
| 基金项目:内蒙古自治区自然科学基金项目（2016MS08119） |
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| 中文摘要: |
| 摘要 目的：探讨伤椎置钉与不置钉短节段内固定对胸腰椎爆裂骨折患者临床疗效及血清炎症损伤介质的影响。方法：回顾性分析2017年3月~2018年7月期间内蒙古医科大学第三附属医院骨科收治的269例胸腰椎爆裂骨折患者的临床资料，根据手术方式的不同分为A组（n=131，给予短节段内固定治疗）和B组（n=138，给予伤椎置钉联合短节段内固定治疗），比较两组患者围术期指标、影像学指标、血清炎症损伤介质及并发症。结果：两组术后1周、术后半年、术后1年伤椎椎体前缘高度呈先升高后降低趋势，且B组术后半年、术后1年伤椎椎体前缘高度均低于A组（P<0.05）；两组术后1周、术后半年、术后1年Cobb'S角呈先降低后升高趋势，且B组术后半年、术后1年Cobb'S角均大于A组（P<0.05）。两组患者手术时间、术中出血量、住院时间及并发症发生率比较无差异（P＞0.05）。两组术后3d血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、髓过氧化物酶（MPO）水平均升高（P<0.05），但两组术后3d血清炎症损伤介质比较差异无统计学意义（P＞0.05）。结论：伤椎置钉与不置钉短节段内固定治疗胸腰椎爆裂骨折患者，可获得相似的临床疗效，且对患者损伤程度基本一致，但伤椎置钉在恢复伤椎椎体前缘高度、Cobb'S角方面更优，临床应用价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical effect of short-segment internal fixation with or without screw placement in injured vertebra in patients with thoracolumbar burst fracture and the influence of serum inflammatory damage mediators. Methods: Retrospective analysis of 269 cases of thoracolumbar burst fracture who were treated in orthopaedics department of the Third Affiliated Hospital of Inner Mongolia Medical University from March 2017 to July 2018. The patients were divided into group A (n=131, treated with short-segment internal fixation) and group B (n=138, treated with screw placement in injured vertebra combined with short-segment internal fixation) according to the different surgical methods. Perioperative indicators, imaging indicators, serum inflammatory mediators and complications were compared between the two groups. Results: In the two groups, the height of injured vertebral anterior edge increased first and then decreased at 1 week after operation, half a year after operation and one year after operation, and the height of injured vertebral anterior edge in group B was shorter than that in group A (P<0.05). Cobb'S angle in two groups decreased first and then increased at 1 week after operation, half a year after operation and one year after operation, and Cobb'S angle in group B at half a year after operation and one year after operation were higher than than in group A (P<0.05). There were no significant differences in operation time, intraoperative bleeding volume, hospitalization time and complications between the two groups (P>0.05). The levels of serum interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and myeloperoxidase (MPO) increased in two groups at 3d after operation (P<0.05), but there was no significant difference between the two groups in the levels of inflammatory mediators at 3d after operation (P>0.05). Conclusion: Short-egment internal fixation for thoracolumbar burst fracture can achieve similar clinical efficacy with or without screw placement in injured vertebra and the degree of injury is basically the same. However, screw placement in injured vertebra can effectively restore the height of injured vertebral anterior edge and Cobb'S angle, which has a high clinical value. |
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