高压氧联合后路三维椎弓根螺钉系统治疗胸腰椎骨折并脊髓损伤疗效观察

摘要

Objective To investigate the effect of hyperbaric oxygen treatment and posterior atlas internal fixation on patients with thoracolumbar spine fracture coupled with spinal cord injury. Methods Ninety -six cases of thoracolumbar spine fracture coupled with spinal cord injury admitted into the hospital from December 2000 to September 2009 were divided into 3 groups: the combined therapeutic group ( the HBO + AF group ), the posterior atlas fixation group (the AF group) and the HBO treatment group (the HBO group). The HBO group was treated purely with 3 sessions of HBO therapy for 30 days with an average of 4.5 days after injury or operation. The AF group was treated simply with posterior atlas internal fixation with an average of 4.3 days after injury. The treatment effects of the three groups were studied respectively after therapy. Close observations were made on the effects of both HBO treatment and posterior atlas internal fixation and also prognosis of each group. Results The effective rate of the combined therapeutic group was 92.8 %, while those of the AF group and the pure HBO group were 71.4 % and 52.6 % respectively. The combined therapeutic group showed better treatment effects than the AF group ( P ＜ 0.05 ) and the HBO group ( P ＜0. 01 ). Conclusions Posterior atlas internal fixation combined with HBO treatment produced obviously better effects than simple posterior atlas internal fixation or pure HBO treatment.%目的 探讨高压氧(HBO)联合后路三维椎弓根螺钉(AF)系统对于胸腰椎骨折并脊髓损伤的治疗效果.方法 将2000年12月至2009年9月收治的96例胸腰椎骨折并脊髓损伤患者根据治疗方法 不同分为联合治疗组(HBO+AF)42例,AF组35例,HBO组19例,观察各组治疗效果,总结预后.其中HBO组在伤后或术后平均4.5 d接受3个疗程共30 d HBO治疗,AF组在伤后平均4.3 d接受后路AF系统方法 治疗.结果 HBO+AF组有效率92.8%,AF组有效率71.4%,HBO组有效率52.6%.HBO+AF组疗效优于AF组(P＜0.05)和HBO组(P＜0.01).结论 HBO联合后路AF系统治疗胸腰椎骨折并脊髓损伤较单纯后路AF系统治疗及HBO治疗有更好的疗效.