| 胸腰段脊柱骨折前路手术技术改良的临床研究 |
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投稿时间：2005-11-29
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈经勇 |
CHEN Jing-yong |
四川省骨科医院,四川成都610041 |
Sichuan Province Orthopaedics Hospital,Chengdu 610041,Sichuan,China |
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| 万趸 |
WAN Dun |
四川省骨科医院,四川成都610041 |
Sichuan Province Orthopaedics Hospital,Chengdu 610041,Sichuan,China |
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| 石华刚 |
SHI Hua-gang |
四川省骨科医院,四川成都610041 |
Sichuan Province Orthopaedics Hospital,Chengdu 610041,Sichuan,China |
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| 陈如见 |
CHEN Ru-jian |
四川省骨科医院,四川成都610041 |
Sichuan Province Orthopaedics Hospital,Chengdu 610041,Sichuan,China |
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| 陈黎 |
CHEN Li |
四川省骨科医院,四川成都610041 |
Sichuan Province Orthopaedics Hospital,Chengdu 610041,Sichuan,China |
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| 邓志强 |
DENG Zhi-qiang |
四川省骨科医院,四川成都610041 |
Sichuan Province Orthopaedics Hospital,Chengdu 610041,Sichuan,China |
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| 期刊信息：《中国骨伤》2006年，第19卷，第8期，第461-463页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨胸腰段脊柱骨折前路手术技术改良的方法及可行性。
方法:因椎管占位、严重后突畸形、需行前路手术减压植骨内固定的78例新鲜胸腰段脊柱骨折分为改良组（A组）和传统组（B组）。A组41例,男26例,女15例;年龄17~58岁,平均38.27岁;Cobb角10°~40°,平均24.71°;椎管占位率35%~80%,平均49.1%;采用倒V形切口,前路减压、钛网植骨内固定。B组37例,男22例,女15例;年龄18~57岁,平均38.73岁;Cobb角15°~38°,平均25.08°;椎管占位率33%~79%,平均48.3%;采用传统前路减压、自体髂骨植骨内固定。两组均采用Z-Plate钉板内固定。对两组间手术时间、出血量、输血量、手术并发症、植骨融合时间、Cobb角、椎管占位率进行统计学处理。
结果:A组39例获平均26个月随访（8~44个月）,B组36例获平均27个月随访（9~38个月）;两组间在性别、年龄、骨折类型、植骨融合时间、Cobb角、椎管占位率方面无统计学差异（P>0.05）。但在手术时间、失血量、输血量、手术并发症方面有显著统计学差异（P<0.01）。
结论:通过改良手术入路,优化手术操作程序,改变植骨方式,能有效地减少胸腰段脊柱骨折前路手术的手术时间、失血量、输血量、降低手术难度及风险和手术并发症。 |
| 【关键词】胸椎 腰椎 脊柱骨折 外科手术 |
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| Clinical study of modified technique for anterior operation of thoracolumbar fracture |
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ABSTRACT
Objective:To study the methods of modified technique for anterior operation of thoracolumbar fracture.
Methods:Seventy-eight patients of thoracolumbar fracture were divided into two groups.In group A,41 patients(26 male and 15 female;the average age of 38.27 years ranging from 17 to 58 years;the mean Cobb angle of 24.71° ranging from 10° to 40°;spinal canal occupational ratio from 35% to 80%, mean 49.10%)were treated by through“V”shape surgical incision, anterior approach decompression and Ti mesh bone transplantation and fixation.In group B,37 patients(22 male and 15 female;the average age of 38.73 years ranging from 18 to 57 years;the mean Cobb angle of 25.08° ranging from 15° to 38°;spinal canal occupational ratio from 33% to 79%,mean 48.30%)were treated through traditional anterior approach decompression,iliac bone autograft and fixation.All patients of two groups were fixed with Z-Plate system.Operative time,blood loss,blood transfusion,complication,fusion time,Cobb angle and spinal stenosis(P>0.05) of two groups were compared through statistical test.
Results:In group A,39 patients were followed-up for 8 to 44 months (average 26 months).In group B,36 patients were followed-up for 9 to 38 months (average 27 months).There were no significant differences between two groups regarding the sex, age, type of fractures,fusion time,Cobb angle and spinal stenosis(P>0.05).But there were significant differences between two groups regarding the operation time,blood loss,blood transfusion,complication(P<0.01).
Conclusion:Modified anterior approach and surgical procedures is helpful to reduce operative injuries, complications,blood loss and blood transfusion. |
| KEY WORDS Thoracic vertebrae Lumbar vertebrae Spinal fractures Surgical procedures, operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈经勇,万趸,石华刚,陈如见,陈黎,邓志强.胸腰段脊柱骨折前路手术技术改良的临床研究[J].中国骨伤,2006,19(8):461~463 |
| 英文格式: | CHEN Jing-yong,WAN Dun,SHI Hua-gang,CHEN Ru-jian,CHEN Li,DENG Zhi-qiang.Clinical study of modified technique for anterior operation of thoracolumbar fracture[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(8):461~463 |
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