本文選題：胸腰椎骨折 + 過伸復(fù)位��； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究課題旨在觀察與分析過伸復(fù)位法結(jié)合椎弓根釘內(nèi)固定術(shù)治療胸腰椎骨折的臨床療效,通過與傳統(tǒng)后路切開復(fù)位內(nèi)固定術(shù)的對比研究,評價過伸復(fù)位法結(jié)合椎弓根釘內(nèi)固定術(shù)在臨床治療上的應(yīng)用價值。方法:本研究選取2016年01月至2017年01月在廈門大學(xué)附屬福州第二醫(yī)院脊柱外科住院的符合納排標(biāo)準(zhǔn)的60例T12-L2胸腰椎骨折患者,根據(jù)住院先后順序編號,按照隨機數(shù)字表法分為治療組和對照組,兩組均為30例。實驗組在全麻下過伸復(fù)位法結(jié)合椎弓根釘內(nèi)固定術(shù);對照組在全麻下行傳統(tǒng)后路切開復(fù)位內(nèi)固定術(shù)。并以治療前后的疼痛評分、Cobb角度改變、椎體前后緣高度恢復(fù)率及丟失率、手術(shù)時間、出血量作為臨床觀察指標(biāo),比較兩組間及各組內(nèi)治療前后不同時段的差異性,并記錄術(shù)后不良反應(yīng)的發(fā)生情況。結(jié)果:兩組60例患者均獲得隨訪,隨訪時間3個月,所有患者均能配合治療。實驗組的手術(shù)時間較對照組平均縮短約26.5分鐘(P0.01),術(shù)中出血量無明顯差異(P0.05)。兩組患者在治療后的疼痛數(shù)字模擬評分上均有明顯改善(P0.01),組間差異無統(tǒng)計學(xué)意義(P0.05)。術(shù)后即刻兩組治療結(jié)果均能夠有效改善Cobb角度及椎體前后緣高度(P0.01);在隨訪時兩組患者的Cobb角度均有一定程度丟失(P0.01),術(shù)后6周椎體前緣高度丟失有明顯差異(P0.01),術(shù)后6周至12周椎體前緣高度丟失無明顯差異(P0.05),各時間段組間對比差異無統(tǒng)計學(xué)意義(P0.05)。60例患者中僅1例出現(xiàn)切口愈合不良,未出現(xiàn)其他嚴重的并發(fā)癥及意外事件。結(jié)論:與傳統(tǒng)后路切開復(fù)位內(nèi)固定術(shù)相比,過伸復(fù)位法結(jié)合椎弓根釘內(nèi)固定術(shù)同樣可以有效緩解患者疼痛,改善術(shù)后患者Cobb角及傷椎高度,并且能夠明顯縮短手術(shù)時間,降低手術(shù)難度。該方法將中醫(yī)手法復(fù)位與西醫(yī)手術(shù)相結(jié)合,是安全、有效的,是對胸腰椎骨折治療的有益補充。
[Abstract]:Objective: to observe and analyze the clinical effect of extension reduction combined with pedicle screw fixation in the treatment of thoracolumbar fractures. To evaluate the clinical value of extension reduction combined with pedicle screw fixation. Methods: from January 2016 to January 2017, 60 patients with T12-L2 thoracolumbar fractures who were hospitalized in the Department of Spinal surgery, Fuzhou Hospital affiliated to Xiamen University, were selected and numbered according to the order of hospitalization. According to the method of random digital table, 30 cases were divided into treatment group and control group. The experimental group was treated with extension reduction under general anesthesia combined with pedicle screw fixation, while the control group was treated with traditional posterior open reduction and internal fixation under general anesthesia. The changes of Cobb angle before and after treatment, the recovery rate and loss rate of anterior and posterior edge of vertebral body, the time of operation and the amount of blood loss were used as clinical observation indexes to compare the differences between the two groups and between the two groups before and after treatment. The incidence of adverse reactions after operation was recorded. Results: 60 patients in both groups were followed up for 3 months. The operative time of the experimental group was 26.5 minutes shorter than that of the control group (P 0.01). There was no significant difference in the blood loss during the operation between the experimental group and the control group (P 0.05). The pain numerical analogue scores of the two groups were significantly improved after treatment (P 0.01), but there was no significant difference between the two groups (P 0.05). Immediately after operation, the results of treatment in both groups could effectively improve the angle of Cobb and the height of anterior and posterior edge of vertebral body P0.01.The Cobb angle of the two groups was lost to a certain extent at the follow-up, and there was significant difference in the loss of anterior height of vertebral body 6 weeks after operation (P 0.01), and there was a significant difference in the loss of anterior height of vertebral body 6 weeks after operation (P 0.01). From 6 to 12 weeks, there was no significant difference in the loss of anterior height of vertebral body (P 0.05). There was no significant difference in comparison between different groups (P 0.05), and only 1 case had poor wound healing in 6 weeks to 12 weeks. There were no other serious complications or accidents. Conclusion: compared with the traditional posterior open reduction and internal fixation, extension reduction combined with pedicle screw fixation can effectively relieve pain, improve the Cobb angle and the height of injured vertebrae, and shorten the operation time. Reduce the difficulty of operation. This method is safe and effective and is a useful supplement to the treatment of thoracolumbar fractures.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

【相似文獻】

相關(guān)期刊論文 前10條

1 賀亮,張磊,吳建平,湯義斌,陳孟根,王長青;過伸復(fù)位法治療屈曲型胸腰椎骨折療效分析[J];中醫(yī)正骨;2001年09期

2 周小敏;;腰橋過伸復(fù)位治療胸腰椎壓縮性骨折[J];浙江臨床醫(yī)學(xué);2008年04期

3 王森;王翔;沙良寬;張霞;侯勇;;過伸復(fù)位結(jié)合經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性椎體骨折[J];組織工程與重建外科雜志;2009年02期

4 劉效敏;張俊忠;;過伸復(fù)位外固定法治療胸腰椎壓縮性骨折的臨床研究[J];世界中西醫(yī)結(jié)合雜志;2009年07期

5 洪篤瑞;黃明鎮(zhèn);李永龍;;過伸復(fù)位法治療胸腰椎壓縮性骨折50例[J];中醫(yī)外治雜志;2009年05期

6 卞泗善;蘇慶紅;張俊忠;;過伸復(fù)位外固定法治療胸腰椎壓縮性骨折[J];中國中西醫(yī)結(jié)合外科雜志;2010年03期

7 趙勇;竺湘江;范ng;李建波;;體位過伸復(fù)位聯(lián)合經(jīng)皮椎體后凸成形術(shù)治療老年骨質(zhì)疏松性椎體壓縮骨折[J];中國微創(chuàng)外科雜志;2013年04期

8 鄭建河;陳陽生;陳歌海;葉握球;林惠華;陳曉生;;過伸復(fù)位與經(jīng)皮椎體后凸成形術(shù)聯(lián)合治療骨質(zhì)疏松性胸腰椎壓縮性骨折[J];廣東醫(yī)學(xué);2010年15期

9 印紅兵;;過伸復(fù)位加腰椎牽引法治療胸腰椎壓縮性骨折38例[J];黑龍江中醫(yī)藥;2011年05期

10 劉迎軍;李孝林;;有限元分析過伸復(fù)位治療胸腰椎壓縮性骨折的椎間盤動態(tài)力學(xué)[J];中國組織工程研究與臨床康復(fù);2011年04期

相關(guān)會議論文 前7條

1 楊春平;;早期過伸復(fù)位在穩(wěn)定性脊椎損傷中的應(yīng)用[A];“加入WTO和科學(xué)技術(shù)與吉林經(jīng)濟發(fā)展——機遇·挑戰(zhàn)·責(zé)任”吉林省第二屆科學(xué)技術(shù)學(xué)術(shù)年會論文集（下）[C];2002年

2 竺湘江;趙勇;范ng;李建波;;體位過伸復(fù)位結(jié)合后路短節(jié)段傷椎置釘治療胸腰椎骨折[A];2012年浙江省骨科學(xué)術(shù)年會論文集[C];2012年

3 趙勇;竺湘江;范ng;李建波;;體位過伸復(fù)位結(jié)合PKP治療老年骨質(zhì)疏松性椎體骨折[A];2012年浙江省骨科學(xué)術(shù)年會論文集[C];2012年

4 熊焱昊;杜寧;唐旭生;劉濤;傅文_g;;改良過伸復(fù)位治療骨質(zhì)疏松性腰椎壓縮性骨折[A];第十三屆全國中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會論文集[C];2005年

5 王罡;趙鋼;孫敬華;劉大凱;;手法過伸復(fù)位加經(jīng)皮椎體成形術(shù)(PVP)治療椎體壓縮骨折45例[A];第十九屆全國中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會論文匯編[C];2012年

6 周英杰;史相欽;鄭懷亮;崔宏勛;趙剛;;過伸復(fù)位后行椎體強化成形術(shù)治療 骨質(zhì)疏松性脊椎壓縮骨折[A];2009第十七屆全國中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會論文匯編[C];2009年

7 楊春雷;王罡;劉挺;關(guān)智宇;;過伸復(fù)位加經(jīng)皮椎體成形術(shù)(PVP)治療椎體壓縮骨折24例[A];第十六屆全國中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會暨中西醫(yī)結(jié)合手法治療骨傷科疾病新進展學(xué)習(xí)班論文匯編[C];2008年

相關(guān)博士學(xué)位論文 前1條

1 李孝林;胸腰椎壓縮性骨折有限元模型的建立及過伸復(fù)位治療的生物力學(xué)分析[D];湖北中醫(yī)學(xué)院;2009年

相關(guān)碩士學(xué)位論文 前2條

1 卞泗善;過伸復(fù)位外固定法治療胸腰椎壓縮性骨折操作規(guī)范[D];山東中醫(yī)藥大學(xué);2006年

2 劉玉江;過伸復(fù)位外固定治療胸腰椎壓縮性骨折的臨床研究[D];山東中醫(yī)藥大學(xué);2004年

，

本文編號：1915581