经伤椎置单向椎弓根螺钉结合十七味大活血胶囊治疗无神经损伤胸腰椎压缩性骨折疗效观察
|
摘要
目的观察伤椎置入单向椎弓根螺钉结合十七味大活血胶囊口服在无神经损伤胸腰椎压缩性骨折治疗中的效果。方法将67例无神经损伤胸腰椎骨折患者,根据患者最终选取的治疗方案分为对照组(n=45)和观察组(n=22)。对照组给予跨伤椎固定的基础上再经伤椎置入单向椎弓根螺钉固定,观察组在对照组的基础上使用自制十七味大活血胶囊口服。分别观察两组治疗前、治疗后1周、治疗后3个月椎前缘高度、椎中缘高度和后凸角度,视觉模拟量表(visual analogue scale,VAS)评分,日本骨科协会(Japanese Orthopaedic Association,JOA)评分。结果与治疗前比较,两组治疗后1周、3个月椎前缘高度、椎中缘高度均明显增加(P<0.05),后凸角度均明显减小(P<0.05);观察组治疗后3个月椎前缘、椎中缘高度均明显高于对照组(P<0.05)。与治疗前比较,两组治疗后VAS评分在治疗后1周、3个月均明显减少(P<0.05),JOA评分均明显增加(P<0.05)。观察组治疗后VAS评分在治疗后1周、3个月均显著低于对照组(P<0.05),JOA评分明显高于对照组(P<0.05)。结论经伤椎置入单向椎弓根螺钉结合十七味大活血胶囊口服更利于伤椎前中柱交界处的复位,临床疗效更好。
Objective To investigate the clinical effect of one-way pedicle screw placement via the injured vertebrae combined with Shiqiwei Dahuoxue Capsule in the treatment of thoracolumbar vertebral compression fracture without nerve injury.Methods A total of 67 patients with thoracolumbar vertebral compression fracture without nerve injury were enrolled,and according to the treatment regimen they selected,they were divided into control group with 45 patients and observation group with 22 patients.The patients in the control group were given fixation across the injured vertebrae combined with one-way pedicle screw placement via the injured vertebrae,and those in the observation group were given self-made Shiqiwei Dahuoxue Capsule in addition to the treatment in the control group.Anterior height,midline height,and kyphosis of the injured vertebrae,Visual Analogue Scale(VAS)score,and Japanese Orthopaedic Association(JOA)score were observed before treatment and at 1 week and 3 months after treatment.Results At 1 week and 3 months after treatment,both groups had significant increases in anterior height and midline height of the injured vertebrae(P<0.05)and a significant reduction in kyphosis of the injured vertebrae(P<0.05);at3 months after treatment,the observation group had significantly higher anterior height and midline height of the injured vertebrae than the control group(P<0.05).At 1 week and 3 months after treatment,both groups had a significant reduction in VAS score(P<0.05)and a significant increase in JOA score(P<0.05),and the observation group had a significantly lower VAS score and a significantly higher JOA score compared with the control group(both P<0.05).Conclusion One-way pedicle screw placement via the injured vertebrae combined with Shiqiwei Dahuoxue Capsule helps with the reduction at the junction of the anterior and central column of the injured vertebrae and thus has a good clinical effect.
Objective To investigate the clinical effect of one-way pedicle screw placement via the injured vertebrae combined with Shiqiwei Dahuoxue Capsule in the treatment of thoracolumbar vertebral compression fracture without nerve injury.Methods A total of 67 patients with thoracolumbar vertebral compression fracture without nerve injury were enrolled,and according to the treatment regimen they selected,they were divided into control group with 45 patients and observation group with 22 patients.The patients in the control group were given fixation across the injured vertebrae combined with one-way pedicle screw placement via the injured vertebrae,and those in the observation group were given self-made Shiqiwei Dahuoxue Capsule in addition to the treatment in the control group.Anterior height,midline height,and kyphosis of the injured vertebrae,Visual Analogue Scale(VAS)score,and Japanese Orthopaedic Association(JOA)score were observed before treatment and at 1 week and 3 months after treatment.Results At 1 week and 3 months after treatment,both groups had significant increases in anterior height and midline height of the injured vertebrae(P<0.05)and a significant reduction in kyphosis of the injured vertebrae(P<0.05);at3 months after treatment,the observation group had significantly higher anterior height and midline height of the injured vertebrae than the control group(P<0.05).At 1 week and 3 months after treatment,both groups had a significant reduction in VAS score(P<0.05)and a significant increase in JOA score(P<0.05),and the observation group had a significantly lower VAS score and a significantly higher JOA score compared with the control group(both P<0.05).Conclusion One-way pedicle screw placement via the injured vertebrae combined with Shiqiwei Dahuoxue Capsule helps with the reduction at the junction of the anterior and central column of the injured vertebrae and thus has a good clinical effect.
引文
[1]胡益文.骨质疏松患者胸腰椎压缩性骨折PKP术后再发骨折的风险因素分析[J].生物骨科材料与临床研究,2017,14(5):52-55.
[2]缪寿亮,周湘兰,郑祥武,等.胸腰椎压缩性骨折压缩程度评估方法比较[J].中国法医学杂志,2016,31(2):171-173.
[3]徐建达,高益,赵洪,等.Viper脊柱微创系统和椎弓根螺钉内固定修复胸腰椎压缩性骨折[J].中国组织工程研究,2016,20(44):6583-6589.
[4]周英杰,孟宪杰.微创经皮椎弓根螺钉内固定治疗胸腰椎骨折的研究进展[J].中华创伤杂志,2016,32(5):464-468.
[5]黄立军,夏庆福,王伟,等.单侧椎弓根旁入路经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折研究[J].现代仪器与医疗,2016,22(2):88-90.
[6]朱瑜琪,王金荣.腰椎融合及植入物内固定后滑脱腰椎的椎体稳定性[J].中国组织工程研究,2013,17(35):6339-6344.
[7]RUIZ S F,TOMDS M P,MOYA S E,et al.Classifying thoracolumbar fractures:role of quantitative imaging[J].Quant Imaging Med Surg,2016,6(6):772-784.
[8]刘思景,郑臣校,李绪松,等.中医三期治则对骨折愈合影响的机制研究[J].中国现代药物应用,2018,12(6):221-222.
[9]吴毅,何河北,孙永建,等.经伤椎置钉与跨节段椎弓根螺钉置入固定修复胸腰椎骨折的Meta分析[J].中国组织工程研究,2015,19(22):3604-3608.
[10]李晶,吕国华,王冰,等.胸腰椎骨折脱位伤椎固定的可行性研究[J].中华骨科杂志,2005,25(5):293-296.
[11]庞仲辉,张亚斌,姚永峰,等.后路复位内固定与经椎弓根伤椎植骨置钉治疗胸腰椎骨折的临床疗效及神经功能恢复情况[J].临床和实验医学杂志,2015(17):1426-1428.
[12]张世磊,张永峰,闫铭,等.经伤椎螺钉固定与跨伤椎螺钉固定治疗胸腰椎骨折疗效对比[J].空军医学杂志,2016,32(3):182-184.
[13]赖宇锐,倪增良,何建群.两种不同手术方式治疗无神经损伤胸腰椎骨折的疗效及安全性对比[J].浙江中西医结合杂志,2017,27(10):781-785.
[14]王许可,周英杰,李长青,等.联合万向钉和单向钉治疗胸腰椎爆裂骨折的生物力学稳定性研究[J].中华创伤杂志,2014,30(2):160-163.
[15]ULUTAS M,SECER M,CELIK S E.Minimally invasive mini open split muscular percutaneous pedicle screw fixation of the thoracolumbar spine[J].Orthop Rev(Pavia),2015,7(1):5661-5567.
[16]杜容娇.综合护理干预对骨质疏松性胸腰椎压缩骨折患者疼痛症状与生活质量的影响研究[J].临床与病理杂志,2015(6):1113-1116.
[17]颜升,曾金祥,毕莹,等.车前子提取物对正常大鼠利尿活性及肾脏水通道蛋白与离子通道的作用[J].中国医院药学杂志,2014,34(12):968-971.
[18]汪健,孙雁群,何升华,等.熨洗Ⅰ号熏洗对胫骨平台骨折术后关节功能的影响[J].安徽中医药大学学报,2016,35(2):27-29.
[2]缪寿亮,周湘兰,郑祥武,等.胸腰椎压缩性骨折压缩程度评估方法比较[J].中国法医学杂志,2016,31(2):171-173.
[3]徐建达,高益,赵洪,等.Viper脊柱微创系统和椎弓根螺钉内固定修复胸腰椎压缩性骨折[J].中国组织工程研究,2016,20(44):6583-6589.
[4]周英杰,孟宪杰.微创经皮椎弓根螺钉内固定治疗胸腰椎骨折的研究进展[J].中华创伤杂志,2016,32(5):464-468.
[5]黄立军,夏庆福,王伟,等.单侧椎弓根旁入路经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折研究[J].现代仪器与医疗,2016,22(2):88-90.
[6]朱瑜琪,王金荣.腰椎融合及植入物内固定后滑脱腰椎的椎体稳定性[J].中国组织工程研究,2013,17(35):6339-6344.
[7]RUIZ S F,TOMDS M P,MOYA S E,et al.Classifying thoracolumbar fractures:role of quantitative imaging[J].Quant Imaging Med Surg,2016,6(6):772-784.
[8]刘思景,郑臣校,李绪松,等.中医三期治则对骨折愈合影响的机制研究[J].中国现代药物应用,2018,12(6):221-222.
[9]吴毅,何河北,孙永建,等.经伤椎置钉与跨节段椎弓根螺钉置入固定修复胸腰椎骨折的Meta分析[J].中国组织工程研究,2015,19(22):3604-3608.
[10]李晶,吕国华,王冰,等.胸腰椎骨折脱位伤椎固定的可行性研究[J].中华骨科杂志,2005,25(5):293-296.
[11]庞仲辉,张亚斌,姚永峰,等.后路复位内固定与经椎弓根伤椎植骨置钉治疗胸腰椎骨折的临床疗效及神经功能恢复情况[J].临床和实验医学杂志,2015(17):1426-1428.
[12]张世磊,张永峰,闫铭,等.经伤椎螺钉固定与跨伤椎螺钉固定治疗胸腰椎骨折疗效对比[J].空军医学杂志,2016,32(3):182-184.
[13]赖宇锐,倪增良,何建群.两种不同手术方式治疗无神经损伤胸腰椎骨折的疗效及安全性对比[J].浙江中西医结合杂志,2017,27(10):781-785.
[14]王许可,周英杰,李长青,等.联合万向钉和单向钉治疗胸腰椎爆裂骨折的生物力学稳定性研究[J].中华创伤杂志,2014,30(2):160-163.
[15]ULUTAS M,SECER M,CELIK S E.Minimally invasive mini open split muscular percutaneous pedicle screw fixation of the thoracolumbar spine[J].Orthop Rev(Pavia),2015,7(1):5661-5567.
[16]杜容娇.综合护理干预对骨质疏松性胸腰椎压缩骨折患者疼痛症状与生活质量的影响研究[J].临床与病理杂志,2015(6):1113-1116.
[17]颜升,曾金祥,毕莹,等.车前子提取物对正常大鼠利尿活性及肾脏水通道蛋白与离子通道的作用[J].中国医院药学杂志,2014,34(12):968-971.
[18]汪健,孙雁群,何升华,等.熨洗Ⅰ号熏洗对胫骨平台骨折术后关节功能的影响[J].安徽中医药大学学报,2016,35(2):27-29.