本文選題：胸腰段　切入點：脊柱骨折　出處：《新疆醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的：比較前路與后路手術治療胸腰段脊柱骨折的療效。方法：回顧性分析蘭州軍區(qū)烏魯木齊總醫(yī)院2009年1月-2012年1月73例胸腰段脊柱骨折的患者,其中后路手術42例(A組),前路手術31例(B組)。查閱病例及相關資料記錄兩組患者的年齡、性別、致傷原因、是否合并有慢性疾病、手術時間、術中出血量及兩組患者手術前后觸覺評分、運動評分、cobb's角、傷椎高度、脊髓功能分級,術后并發(fā)癥、術后患者有效率等數(shù)據(jù)資料。結果：1.兩組術前ASIA分級、觸覺評分、運動評分、cobb's角、傷椎高度比較無差異(P0.05)；2.兩組手術時間及術中出血量比較有明顯差異(P0.05),A組優(yōu)于B組；3.兩組術后觸覺評分、運動評分、cobb's角、傷椎高度比較,有統(tǒng)計學差異(P0.05),B組優(yōu)于A組；4.兩組術后觸覺評分、運動評分、cobb's角、傷椎高度均較術前有統(tǒng)計學差異(P0.05),兩組術后較術前均有明顯改善；5.兩組病例療效比較,顯效與無效兩組之間比較無差異(P0.05),有效兩組之間比較有差異(P0.05),總有效率兩組無差異(P0.05)。結論：成人胸腰段脊柱骨折,前后路手術入路均有效,總有效率無明顯差異。后路手術入路操作相對簡單,手術時間短、出血量少,而前路手術入路操作復雜,術中出血量多,但其脊髓神經功能恢復相對較好,更有利于恢復脊柱穩(wěn)定性,值得臨床推廣。
[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.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3
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本文編號：1615183