復位床托快速復位法和經皮穿刺椎體成形術治療胸腰椎壓縮性骨折的臨床療效對比

徐文銘　彭力平　余闐等

[摘要] 目的 對自行研制的胸腰椎骨折復位床托與經皮穿刺椎體成形術治療對腰椎壓縮性骨折的臨床療效進行比較與探討。 方法 將60例胸腰椎壓縮性骨折患者分為快速復位組30例和穿刺成形組30例兩組。復位后分3個時段行X線照片，測量并計算其各項指標；并于治療前后行癥狀評分。 結果 資料取證以及統計學分析，快速復位組在治療2周、4周時各項指標均低于穿刺成形組（P < 0.05）；快速復位組在治療2周、4周時各項指標均優于穿刺成形組（P < 0.05）；快速復位組于治療4周、12周時的功能活動的評價明顯高于穿刺成形組（P < 0.01）。 結論 復位床托快速復位法操作方法簡單，操作過程安全可靠，能夠有效地對臨床癥狀、體征、脊柱的活動能力，并且能夠滿足不同年齡段的患者對本療法的治療需要。

[關鍵詞] 胸腰椎壓縮性骨折；體外整復

[中圖分類號] R687.3 [文獻標識碼] B [文章編號] 1673-9701（2014）12-0027-03

[Abstract] Objective To explore and compare the clinical effects of self-developed reduction bed bracket for thoracolumbar fractures and percutaneous vertebroplasty in the treatment of lumbar compression fractures. Methods Sixty patients with thoracolumbar fractures were assigned to a group of fast reduction and a group of percutaneous vertebroplasty， with 30 patients in each group. X-ray was carried out in three different periods of time after reduction， and each index was measured and calculated； symptom scores were obtained before and after the treatment. Results According to related data and statistical analysis， indices in the group of fast reduction in the second and fourth weeks of treatment were all lower than those in the groups of percutaneous vertebroplasty （P < 0.05）； indices in the group of fast reduction in the second and fourth weeks of treatment were all better than those in the group of percutaneous vertebroplasty（P < 0.05）； the evaluation of functional activities in the group of fast reduction in the fourth and twelfth weeks of treatment was significantly higher than that in the group of percutaneous vertebroplasty （P < 0.01）. Conclusion The fast reduction method by reduction bed bracket has an easy operational method and a safe and reliable operational procedure， which effectively helps alleviate symptoms， improve physical signs and the activity of vertebral column， and satisfy the treatment demand for patients at different age levels.

[Key words] Thoracolumbar compression fractures； External reduction

胸腰椎壓縮性骨折是臨床的常見病、多發病，對人民健康和生活質量有嚴重的影響。根據查閱資料獲知，胸腰椎骨折占脊柱骨折的87.34%[1]，是骨科臨床的常見病和多發病。隨著我國人口老齡化的進程不斷加快，交通運輸業和建筑業的不斷發展，胸腰椎壓縮性骨折有上升的趨勢。此病會導致患者長時間臥床以及并發癥的產生，嚴重影響了人民健康和生活質量。

1 資料與方法

1.1 基本資料

選擇2011年7月～2013年10月來我院進行治療的胸腰椎壓縮性骨折住院患者60例，將其隨機分為快速復位組和穿刺成形組各30例。快速復位組平均年齡（40.81±16.33）歲，共40椎，剩余的椎體前緣高度為36.5%～92.3%；其中T10共2椎，T11共2椎，T12共8椎，L1共20椎，L2共6椎，L3共2椎；病程1～3 d，平均（1.21±0.88）d。穿刺成形組平均年齡（40.83±16.29）歲，共39椎，剩余的椎體前緣高度為34.5%～90.1%；其中T10共2椎，T11共1椎，T12共11椎，L1共19椎，L2共4椎，L3共2椎；病程1～3 d，平均（1.31±0.66）d。經統計學分析，兩組患者在壓縮程度、病程、年齡、骨折節段等方面均無顯著差異（P > 0.05），具有可比性。……