[1]李小龙,葛郁龙.经皮钉棒内固定和Wiltse入路切开复位钉棒内固定治疗胸腰椎骨折疗效及对患者椎体形态、创伤因子的影响[J].陕西医学杂志,2022,51(8):986-989.[doi:DOI:10.3969/j.issn.1000-7377.2022.08.019]
　LI Xiaolong,GE Yulong.Efficacy of percutaneous nail-rod internal fixation and Wiltse approach open reduction nail-rod internal fixation for thoracolumbar fractures and its influence on vertebral body morphology and trauma factor levels in patients[J].,2022,51(8):986-989.[doi:DOI:10.3969/j.issn.1000-7377.2022.08.019]
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经皮钉棒内固定和Wiltse入路切开复位钉棒内固定治疗胸腰椎骨折疗效及对患者椎体形态、创伤因子的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年8期
页码:
986-989
栏目:
临床研究
出版日期:
2022-08-05

文章信息/Info

Title:
Efficacy of percutaneous nail-rod internal fixation and Wiltse approach open reduction nail-rod internal fixation for thoracolumbar fractures and its influence on vertebral body morphology and trauma factor levels in patients
作者:
李小龙; 葛郁龙
(宝鸡市人民医院,陕西 宝鸡 721000)
Author(s):
LI Xiaolong; GE Yulong
(Baoji People's Hospital,Baoji 721000,China)
关键词:
胸腰椎骨折;  经皮钉棒内固定;  切开复位钉棒内固定;  椎体形态;  创伤因子;  Wiltse入路
Keywords:
Thoracolumbar fractures;  Percutaneous nail-rod internal fixation;  Open reduction nail-rod internal fixation;  Vertebral body morphology;  Trauma factor;  Wiltse approach
分类号:
R 687.3
DOI:
DOI:10.3969/j.issn.1000-7377.2022.08.019
文献标志码:
A
摘要:
目的:研究经皮钉棒内固定和Wiltse入路切开复位钉棒内固定治疗胸腰椎骨折疗效及对患者椎体形态、创伤因子水平的影响。方法:选取胸腰椎骨折患者69例,根据治疗方法的不同分为A组和B组。A组行Wiltse入路切开复位钉棒内固定术,B组行经皮钉棒内固定术。比较两组的治疗效果、手术指标、椎体形态指标、骨折愈合因子以及创伤因子水平。结果:A组治疗优良率高于B组,差异具有统计学意义(P<0.05)。A组手术时间、切口长度低于B组,术中出血量高于B组,差异具有统计学意义(均P<0.05)。术后6个月,A组伤椎前缘相对高度、后凸Cobb角、矢状位指数均优于B组,差异具有统计学意义(均P<0.05)。术后4周,A组的血小板衍生生长因子(PDGF)、Ⅰ型胶原氨基端前肽(PINP)、抗酒石酸盐酸性磷酸酶异构体5b(TRACP-5b)水平优于B组,差异具有统计学意义(均P<0.05)。术后3 d,两组白介素(IL)-18、皮质醇(Cor)、C反应蛋白(CRP)水平比较,差异无统计学意义(均P>0.05)。结论:经皮钉棒内固定和Wiltse入路切开复位钉棒内固定治疗胸腰椎骨折的创伤因子水平相当,然而Wiltse入路切开复位钉棒内固定在疗效、患者椎体形态和骨折愈合因子改善方面效果更佳,值得临床推广。
Abstract:
Objective:To study the efficacy of percutaneous nail-rod internal fixation and Wiltse approach open reduction nail-rod internal fixation for thoracolumbar fractures and its influence on vertebral body morphology and trauma factor levels in patients.Methods:A total of 69 patients with thoracolumbar fractures were selected and divided into group A and group B according to different treatment methods.The group A received Wiltse approach open reduction nail-rod internal fixation,and group B received percutaneous nail-rod internal fixation.The treatment effect,surgical indexes,vertebral body shape indexes,fracture healing factor and trauma factor levels were compared between the two groups.Results:The excellent and good rate of group A was higher than that of group B(P<0.05).The operation time and incision length of group A were lower than those of group B,and the intraoperative blood loss was higher than that of group B(all P<0.05).Six months after the operation,the relative height of the anterior edge of the injured vertebra,the kyphotic Cobb angle and the sagittal index in group A were better than those in group B(all P<0.05).Four weeks after operation,the levels of PDGF,PINP and TRACP-5b in group A were better than those in group B(all P<0.05).Three days after operation,there was no significant difference in the levels of interleukin(IL)-18,cortisol(Cor)and C- reactive protein(CRP)between the two groups(all P>0.05).Conclusion:Percutaneous nail-rod fixation and Wiltse approach open reduction nail-rod internal fixation in the treatment of thoracolumbar vertebral fractures have similar trauma factor levels.However,the Wiltse approach open reduction nail-rod internal fixation has better effect in terms of curative effect,vertebral body shape and fracture healing factors.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2017YHB08)
更新日期/Last Update: 2022-08-04