不同手术方法治疗胸腰椎骨折的临床疗效比较.docVIP

不同手术方法治疗胸腰椎骨折的临床疗效比较 　　[摘要] 目的 探?比较不同手术方法治疗胸腰椎骨折的临床效果。方法 方便选取2014年6月―2016年7月期间在该院进行诊断治疗的胸腰椎骨折且符合手术指征的患者120例，按手术方法不同随机平均分为治疗组1、治疗组2和治疗组3，每组40例。分别行经皮椎体成形术、椎体后凸成形术和微创经皮椎弓根螺钉内固定术。观察3组患者术后病情进展，评估疗效，并分析不同方法的利弊。结果 治疗组1平均手术时间最短，为（0.45±0.20）h，平均骨水泥注入量（3.1±1.50）mL，较节约成本；治疗组2术中失血量少，平均失血量为（15.7±2.60）mL，骨水泥渗漏率10.0%，疗效较好；治疗组3手术创口微小，但手术时间较长；3组患者手术情况比较差异有统计学意义（P70.0%，患者术后椎体高度均有上升，VAS评分分数均有下降，表明手术治疗效果良好，但3组患者脊柱减压有效率、椎体平均高度、VAS评分方面比较差异无统计学意义（P0.05）。结论 经皮椎体成形术、椎体后凸成形术和微创经皮椎弓根螺钉内固定术对于治疗胸腰椎骨折均有良好的临床效果，经皮椎体成形术手术时间短、耗材少，椎体后凸成形术术中失血量少、骨水泥渗漏率低，微创经皮椎弓根螺钉内固定术创口小，疗效明显。临床治疗应根据病情指征选择合适的手术方法。 　　[关键词] 经皮椎体成形术；椎体后凸成形术；微创经皮椎弓根螺钉内固定术；胸腰椎骨折；临床疗效比较 　　[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2017）02（b）-0057-03 　　[Abstract] Objective To discuss the clinical effect of different operation methods in treatment of thoracolumbar fractures. Methods 120 cases of patients with thoracolumbar fractures and meeting the operation signs in our hospital from June 2014 to July 2016 were convenient selected and randomly divided into three groups with 40 cases in each according to different operation methods， the treatment group 1 were treated with percutaneous vertebroplasty， the treatment group 2 were treated with kyphonplasty， the treatment group 3 were treated with percutaneous pedicle screw fixation operation， and the postoperative disease progress of the three groups was observed and the curative effect was evaluated and the advantages and disadvantages of different methods were analyzed. Results The average operation time in the treatment group 1 was the shortest， （0.45±0.20）h， and the average amount of bone cement injection was （3.1±1.50）mL， and in the treatment group 2， the intraoperative blood loss was less， and the average blood loss was （15.7±2.60）mL， and the leakage rate of bone cement was 10.0%， and the curative effect was good， in the treatment group 3， the operation wound is small， but the operation time was longer， and the difference in the operation condition between the three groups had statistical