摘要
目的:探究微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的疗效及术后切口感染者血清炎症因子、免疫指标的变化。方法:选取我院2015年4月~2019年3月骨科收治的80例胸腰椎骨折患者为研究对象,利用数字法随机分为观察组与对照组,每组各40例,对照组采用传统开放手术治疗,观察组采用微创经皮椎弓根螺钉内固定术治疗。比较两组患者围手术期各指标、椎体前缘高度、椎体矢状面指数和Cobb角、视觉模拟疼痛评分(VAS)以及切口感染发生情况、血清炎症因子和免疫指标水平。结果:观察组患者与对照组患者围术期指标比较,观察组的术后住院时间更短,切口长度更短,术中出血量和术后引流量更少;手术后,两组患者椎体前缘高度和椎体矢状面指数均显著升高,Cobb角均显著下降;两组患者术后切口VAS评分比较,观察组显著小于对照组,差异有统计学意义;两组患者血清炎症因子和免疫指标检测情况比较,感染组患者的血清炎症因子指标C-反应蛋白(CRP)、γ干扰素(IFN-γ)、白介素-6(IL-6)和白介素-8(IL-8)水平均显著高于非感染组患者,免疫指标中的免疫粘附促进因子(FEER)、协同肿瘤红细胞花环率(ATER)和直向肿瘤红细胞免疫花环率(DTER)水平均显著低于非感染组,差异有统计学意义。结论:微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折具有较好的临床疗效,能减少感染组患者的血清炎症因子水平,减轻炎症反应和术后疼痛度。
Objective To explore the effect of minimally invasive percutaneous pedicle screw fixation for thoracolumbar fractures and the changes of serum inflammatory factors and immune indicators in patients with incision infection after operation.Methods 80 patients with thoracolumbar fractures admitted to our hospital between April 2015 and March 2019 were randomly divided into the observation group and the control group with 40 cases in each group.The control group was treated with traditional open surgery,while the observation group was treated with minimally invasive percutaneous pedicle screw internal fixation.Perioperative indexes,anterior vertebral height,sagittal index,Cobb angle,the visual analogue pain score(VAS),incision infection,serum inflammatory factors and immune indexes were compared.Results Compared with the perioperative indicators of the control group,the observation group had shorter hospital stay,shorter incision length,less intraoperative bleeding and less postoperative drainage.After operation,the anterior height of vertebral body and sagittal index of vertebral body increased significantly in both groups,and the Cobb angle decreased significantly.The scores of VAS in the two groups were significantly lower than those in the control group.The levels of serum inflammatory factors,such as C-reactive protein(CRP),Interferon-γ(IFN-γ),Iinterleukin-6(IL-6)and Interleukin-8(IL-8)in the infected group were significantly higher than those in the non-infected group,and the levels of immune adhesion promoting factor(FEER),synergistic tumor erythrocyte rosette rate(ATER)and direct tumor erythrocyte rosette rate(DTER)in immune indexes were significantly lower than those in non-infected group.There was significant difference between non-infected group and non-infected group.Conclusion Minimally invasive percutaneous pedicle screw fixation for thoracolumbar fractures has a good clinical effect,can reduce the level of serum inflammatory factors in patients with infection,reduce inflammation and postoperative pain.
作者
杨斐
张建鹏
郝建学
Yang Fei;Zhang Jian-peng;Hao Jian-xue(Bone surgery Department of Baoding First Hospital,Baoding 071000,China)
出处
《湖南师范大学学报（医学版）》
2020年第5期162-166,共5页
Journal of Hunan Normal University(Medical Sciences)
关键词
胸腰椎骨折
微创经皮椎弓根螺钉内固定术
血清炎症因子
免疫指标
视觉模拟疼痛评分
thoracolumbar fractures
minimally invasive percutaneous pedicle screw fixation
serum inflammatory factors
immune indicators
visual analogue pain score
