本文選題：中醫(yī)手法閉合復(fù)位 + 中重度OVCF��； 參考：《湖北中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的本文研究采用回顧性分析的方法,對術(shù)前麻醉狀態(tài)下的中醫(yī)手法閉合復(fù)位聯(lián)合PKP與單純PKP治療中重度OVCF的臨床療效進(jìn)行比較研究,對中醫(yī)手法閉合復(fù)位聯(lián)合PKP治療中重度OVCF的臨床療效進(jìn)行觀察。方法回顧性分析2012年3月至2015年3月武漢市中西醫(yī)結(jié)合醫(yī)院骨脊柱�？剖兆≡菏中g(shù)治療的128例中重度OVCF患者,其中研究組術(shù)前麻醉狀態(tài)下先予中醫(yī)手法閉合復(fù)位,再行PKP手術(shù)治療,對照組采用單純PKP治療,觀察兩組患者的臨床癥狀改善情況、骨水泥的注入量及滲漏情況、治療前后腰背部疼痛VAS評分、治療前后脊柱節(jié)段后凸Cobb角、治療前后病椎椎體前緣、中間以及后緣的高度,綜合評價(jià)麻醉狀態(tài)下中醫(yī)手法閉合復(fù)位聯(lián)合PKP治療中重度OVCF的臨床療效。結(jié)果1.對于術(shù)中骨水泥的用量方面的比較:研究組在術(shù)前麻醉狀態(tài)下中醫(yī)手法閉合復(fù)位后再行PKP手術(shù)治療能夠增加骨水泥平均注入量,同對照組相相比較,兩組骨水泥的平均注入量的差別存在統(tǒng)計(jì)學(xué)上的意義(p0.05)。2.對于骨水泥滲漏情況方面的比較:兩組病人的骨水泥的滲漏情況治療前后相比差別不存在統(tǒng)計(jì)學(xué)上的意義(p0.05)。3.治療前后的VAS評分比較:兩組病人的疼痛治療3日后均能得到明顯地緩解,研究組治療3日后VAS評分同對照組治療3日后VAS評分相比差異不存在統(tǒng)計(jì)學(xué)上的意義(p0.05);兩組患者在治療3月后較治療3日后疼痛進(jìn)一步減輕,兩組患者之間在治療3月后的VAS疼痛評分相比較差異不存在統(tǒng)計(jì)學(xué)上的意義(p0.05)。4.治療前后的脊柱后凸Cobb角比較:在病人的脊柱后凸畸形矯正方面,兩組病人自身治療前后相比,差異存在統(tǒng)計(jì)學(xué)上的意義(p0.05),兩組治療均能不同程度地緩解病人的脊柱后凸畸形。在矯正病人的脊柱后凸畸形程度方面,兩組病人之間治療3日后的脊柱后凸Cobb角相比,差異存在統(tǒng)計(jì)學(xué)上的意義(p0.05),研究組明顯優(yōu)于對照組;兩組病人之間治療3月后的脊柱后凸Cobb相比差異存在統(tǒng)計(jì)學(xué)上的意義(p0.05),研究組同樣優(yōu)于對照組。5.治療前后的病椎椎體前緣、中間及后緣高度的比較:在恢復(fù)病椎椎體前緣、中間高度方面,兩組病人自身治療前后相比,差異存在統(tǒng)計(jì)學(xué)上的意義(p0.05),兩組治療均能不同程度地恢復(fù)病椎椎體前緣和中間高度;在恢復(fù)病椎椎體后緣高度方面,研究組病人自身治療前后相比,差異存在統(tǒng)計(jì)學(xué)上的意義(p0.05),對照組病人自身治療前后相比,差異不存在統(tǒng)計(jì)學(xué)上的意義(p0.05),研究組能不同程度地恢復(fù)病椎椎體的后緣高度。兩組患者之間治療3日后的病椎椎體前緣、中間高度分別相比,差別存在統(tǒng)計(jì)學(xué)上的意義(p0.05),研究組優(yōu)于對照組;兩組患者之間治療3月后的病椎椎體前緣、中間的高度分別相比,差異存在統(tǒng)計(jì)學(xué)上的意義(p0.05),研究組同樣優(yōu)于對照組。結(jié)論術(shù)前麻醉狀態(tài)下的中醫(yī)手法閉合復(fù)位聯(lián)合PKP治療中重度OVCF可以顯著地改善病人的疼痛,能夠最大限度地矯正病人的脊柱后凸畸形,集合了現(xiàn)代醫(yī)學(xué)微創(chuàng)技術(shù)與中醫(yī)傳統(tǒng)手法的優(yōu)勢,可以最大限度地使病椎椎體高度恢復(fù)到骨折前水平,具有顯著改善病人疼痛、矯正病人的脊柱后凸畸形并且恢復(fù)維持病人的脊柱正常生理弧度等優(yōu)點(diǎn),值得在臨床實(shí)踐中加以推廣。
[Abstract]:Objective to study the clinical efficacy of closed reduction combined with PKP and simple PKP in the treatment of moderate and severe OVCF under preoperative anesthesia, and to observe the clinical efficacy of traditional Chinese medicine closed reduction combined with PKP in the treatment of moderate and severe OVCF. Methods a retrospective analysis from March 2012 to 2015 was conducted. In March, 128 cases of moderate to severe OVCF patients were treated by hospital bone and spine surgery in Wuhan integrated traditional Chinese and Western medicine hospital. The study group was treated with closed reduction of traditional Chinese medicine before operation and PKP operation, and the control group was treated with simple PKP treatment. The improvement of clinical symptoms, the injection amount of bone cement and the leakage of the bone cement were observed. The VAS score of back and back pain before and after treatment, the Cobb angle of spinal segment kyphosis before and after treatment, the height of the anterior, middle and posterior edge of the vertebral body before and after treatment, and evaluate the clinical efficacy of closed reduction of traditional Chinese medicine combined with PKP in the treatment of moderate and severe OVCF under anesthesia. Results 1. comparison of the dosage of bone cement in the operation: the study group was in the study group The average injection of bone cement could be increased after the closed reduction of traditional Chinese medicine and PKP operation under the anesthesia state before operation. Compared with the control group, the difference of the average injection of two groups of cement was statistically significant (P0.05) the comparison of the leakage of bone cement by.2.: the treatment of the leakage of bone cement in the two groups of patients There was no statistical significance (P0.05) before and after treatment (P0.05).3. treatment before and after treatment: two groups of patients with pain treatment could be significantly relieved after 3 days. After 3 days, the study group had no statistically significant difference in VAS score compared with the control group after 3 days of treatment (P0.05); the two groups were compared after the treatment of March. After 3 days of treatment, the pain was further reduced. There was no statistically significant difference in the VAS pain score between the two groups after the March treatment (P0.05) the comparison of the kyphosis Cobb angle before and after the.4. treatment: in the correction of the kyphosis in the patients, the difference was statistically significant between the two groups before and after their own treatment (P0 .05), the two groups were able to alleviate the patients' spinal kyphosis in varying degrees. In the correction of the degree of kyphosis in the patients, there was a statistically significant difference between the two groups of patients after 3 days of treatment of the kyphosis (P0.05), and the study group was obviously superior to the control group; the two groups were treated with spinal kyphosis after March. Cobb compared with the difference of statistical significance (P0.05), the study group was also better than the control group before and after.5. treatment of the vertebral vertebra anterior edge, the middle and the posterior margin of the height of the comparison: in the recovery of the vertebral vertebral anterior margin, the middle height, the two groups of patients before and after the treatment, the difference is statistically significant (P0.05), the two groups of treatment can be different The anterior and middle height of vertebra vertebral body was restored to the extent of the disease. In the recovery of the height of the posterior margin of the vertebral body, there was a statistically significant difference between the patients before and after the treatment of the patients before and after their own treatment (P0.05). The difference was not statistically significant (P0.05) in the control group before and after their own treatment (P0.05), and the study group could recover the vertebral vertebral body in varying degrees. The height of the back edge of the two groups of patients after 3 days of treatment of the vertebral vertebral body edge, the middle height, the difference was statistically significant (P0.05), the study group was better than the control group; the two groups of patients after March, the height of the vertebral vertebral body, the height of the middle of the difference was statistically significant (P0.05), the same group Conclusion the closed reduction of traditional Chinese medicine combined with PKP for the treatment of moderate and severe OVCF can significantly improve the patient's pain, and can correct the patients' spinal kyphosis to the maximum extent, and set the advantages of modern medical minimally invasive technique and traditional Chinese medicine, which can maximize the height of the vertebral body. Back to the pre fracture level, it has the advantages of significantly improving the patient's pain, correcting the patients' spinal kyphosis and restoring the normal physiological radian of the spinal column. It is worth popularizing in clinical practice.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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