| 魏中秋,辛 兵,郭 明,吴 勇,鲍恩虎.后路与前路手术内固定融合术对脊柱骨折患者脊柱功能及创伤应激指标的影响[J].,2021,(7):1292-1295 |
| 后路与前路手术内固定融合术对脊柱骨折患者脊柱功能及创伤应激指标的影响 |
| The Influence of Posterior and Anterior Internal Fixation and Fusion on Spinal Function and Trauma Stress Index in Patients with Spinal Fracture |
| 投稿时间：2020-08-25 修订日期：2020-09-21 |
| DOI：10.13241/j.cnki.pmb.2021.07.020 |
| 中文关键词: 后路手术 前路手术 内固定融合术 脊柱骨折 脊柱功能 创伤应激 |
| 英文关键词: Posterior surgery Anterior surgery Internal fixation and fusion Spinal fracture Spinal function Trauma stress |
| 基金项目:卫生部医药卫生科技发展研究中心项目（W2016ZT0467） |
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| 中文摘要: |
| 摘要 目的：探讨后路与前路手术内固定融合术对脊柱骨折患者脊柱功能及创伤应激指标的影响。方法：选取2015年3月~2019年3月期间徐州医科大学附属医院收治的102例脊柱骨折患者，根据手术方式分为后路组（n=52，后路手术内固定融合术）、前路组（n=50，前路手术内固定融合术），比较两组患者手术相关指标、创伤应激指标、椎体参数、脊柱功能恢复优良率、并发症情况。结果：后路组术后的脊柱功能恢复优良率高于前路组（P<0.05）。后路组手术时间、切口长度、住院时间短于前路组，术中出血量少于前路组（P<0.05）。两组患者术后6个月椎体前缘高度、椎体后缘高度均升高，且后路组高于前路组（P<0.05），Cobb's角降低，且后路组低于前路组（P<0.05）。两组患者术后2周促肾上腺皮质激素（ACTH）、肿瘤坏死因子-α（TNF-α）、皮质醇（Cor）均升高，但后路组低于前路组（P<0.05）。后路组并发症发生率低于前路组（P<0.05）。结论：与前路手术内固定融合术相比，采用后路手术内固定融合术治疗脊柱骨折患者疗效确切，可有效减少创伤应激及并发症发生率，改善患者脊柱功能。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of posterior and anterior internal fixation and fusion on spinal function and trauma stress index in patients with spinal fracture. Methods: 102 patients with spinal fracture in the Affiliated Hospital of Xuzhou Medical University from March 2015 to March 2019 were selected, they were divided into two groups: posterior group (n=52, posterior internal fixation and fusion) and anterior group (n=50, anterior internal fixation and fusion) according to the way of operation. The operative related indexes, trauma stress indexes, vertebral parameters, excellent rate of spinal function recovery and complications of the two groups were compared. Results: The excellent and good recovery rate of spinal function in the posterior group was higher than that in the anterior group (P<0.05). The operation time, incision length and hospitalization time of the posterior group were shorter than those of the anterior group, and the amount of intraoperative bleeding was less than that of the anterior group (P<0.05). 6 months after operation, the height of anterior edge and posterior edge of vertebral body in the two groups increased, and that in the posterior group was higher than that in the anterior group (P<0.05), Cobb's angle decreased and the posterior group was lower than the anterior group (P<0.05). Adrenocorticotropic hormone (ACTH), tumor necrosis factor-α (TNF-α), cortisol (COR) were all increased in the two groups 2 weeks after operation, but they were lower in the posterior group than in the anterior group (P<0.05). The incidence of complications in the posterior group was lower than that in the anterior group (P<0.05). Conclusion: Compared with anterior internal fixation and fusion in the treatment of spinal fracture, posterior internal fixation and fusion can effectively improve the spinal function, reduce the incidence of traumatic stress and complications. |
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