微创与开放经皮椎弓根螺钉内固定治疗单椎体A型胸腰椎骨折的对比研究

摘要

目的 对比分析微创与开放经皮椎弓根螺钉内固定治疗单椎体A型胸腰椎骨折的临床疗效.方法 选取2014年3月至2015年5月期间收治的80例单椎体A型胸腰椎骨折患者.按照随机数表法将患者分为观察组(n=40)和对照组(n=40).观察组采取微创经皮椎弓根螺钉内固定术治疗,对照组采取传统开放椎弓根螺钉内固定术治疗.比较两组患者手术相关指标、临床疗效、疼痛情况、不良反应情况.结果 两组患者手术时间差异无统计学意义(P＞0.05);观察组患者切口长度、术中出血量、术后引流量、住院时间数据均低于对照组患者,差异具有统计学意义(P＜0.05).观察组患者总有效率为97.50％,高于对照组(82.50％),差异有统计学意义(P＜0.05).两组患者术前疼痛情况无统计学意义(P＞0.05);两组患者术后7 d、60 d、120 d疼痛情况持续缓解,且观察组患者疼痛缓解情况比对照组患者好,差异有统计学意义(P＜0.05).治疗后,观察组患者的不良反应发生率(7.50％)明显低于对照组患者(47.50％),差异有统计学意义(P＜0.05).结论 与传统开放经皮椎弓根螺钉内固定术相比,微创经皮椎弓根螺钉内固定术治疗单椎体A型胸腰椎骨折疗效更好,能降低切口长度、术中出血量、术后引流量、住院时间,同时可以更快缓解疼痛,降低不良发生率,安全性高.%Objective To compare the effect of minimally invasive and open percutaneous pedicle screw internal fixation in treatment of thoracolumbar vertebral fractures with single vertebral body A.Methods 80 patients with thoracolumbar vertebral fractures with single vertebral body A from March 2014 to May 2015 in our hospital were researched.They were divided randomly into observation and control groups.40 patients in the observation group,they were treated by minimally invasive percutaneous pedicle screw internal fixation.40 patients in the control group,performed traditional open pedicle screw internal fixation.Surgical data,efficacy,pain,adverse reactions were compared.Results The operation time had no significant difference between the two groups (P＞0.05).Incision length,intraoperative blood loss,postoperative drainage,hospitalization time data of the observation group also were lower than those of the control group with significant differences (P＜0.05).The total effective rate of the observation group (97.50％) was higher than that of the control group (82.50％) with significant difference (P＜0.05).The easement of pain of the observation group was better than that of the control group with significant difference (P＜0.05).The adverse reaction rate of the observation group (7.50％) was lower than that of the control group (47.50％) with significant difference (P＜0.05).Conclusion Minimally invasive percutaneous pedicle screw internal fixation for treatment of single vertebral A type thoracolumbar fractures is better than the traditional open pedicle screw internal fixation,it can shorten the length of the incision and length of hospital stay,reduce the amount of bleeding and postoperative leading flow and can quickly relieve pain,reduce the incidence of adverse reactions,and it is safe.