| 经多裂肌间隙入路治疗胸腰段骨折术后引流对手术疗效影响的相关性分析 |
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投稿时间：2023-08-14
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| 作者 | Author | 单位 | Address | E-Mail |
| 白凡 |
BAI Fan |
皖南医学院弋矶山医院脊柱外科, 安徽 芜湖 241000 |
Department of Spine, Yijishan Hospital, Wannan Medical College, Wuhu 241000, Anhui, China |
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| 王凌挺 |
WANG Ling-ting |
皖南医学院弋矶山医院脊柱外科, 安徽 芜湖 241000 |
Department of Spine, Yijishan Hospital, Wannan Medical College, Wuhu 241000, Anhui, China |
285431720@qq.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第11期，第1062-1068页 |
| DOI：10.12200/j.issn.1003-0034.20230233 |
| 基金项目:2023皖南医学院校级重点科研基金项目(编号:WK202322D14) |
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中文摘要:
目的: 探讨经多裂肌间隙入路治疗胸腰椎骨折术后是否放置引流对手术疗效影响的相关性。
方法: 对2017年1月 至2021年12月 收治的66例胸腰椎骨折患者进行回顾性分析,按术后是否放置引流分为引流组36例与未引流组30例。引流组中男 17例,女 19例;年龄23~68(55.4±9.5)岁;未引流组中男16例,女14例;年龄30~69(53.9±8.3)岁。两组均采用多裂肌间隙入路。选择年龄、性别、骨折部位、损伤节段、手术时间、术中出血量、术前Cobb角、术前椎体前缘高度比、术前日本骨 科学会(Japanese Orthopaedic Association,JOA)评分、术前疼痛视觉模拟评分(visual analogue scale,VAS)、术前Oswestry功能障碍指数(Oswestry disability index,ODI)评分等10个可能影响是否术后引流的因素,应用单因素和多因素Logistic回归分析,研究其对预后的影响,并比较两组术后Cobb角、椎体前缘高度比、JOA、VAS、ODI。
结果: 单因素分析显示术后是否引流可能与患者年龄、是否损伤多节段、手术时间、术中出血量因素相关(P<0.05)。经多因素分析,影响术后是否放置引流的主要因素为年龄、手术时间(P<0.05)。两组在术后随访时Cobb角、椎体前缘高度丢失率、JOA、VAS、ODI比较,差异均无统计学意义(P>0.05)。在并发症方面,未引流组在术后腰痛总发生率低于引流组(P<0.05),两组术后感染、术后神经损伤并发症比较差异无统计学意义(P>0.05)。
结论: 影响多裂肌间隙入路治疗胸腰椎骨折术后是否引流的主要因素是年龄、手术时间,并且术后未引流不会影响手术的远期效果,反而未放置引流能够减少腰痛的方法从而获得更多的收益。 |
| 【关键词】多裂肌间隙入路 胸腰椎骨折 术后引流 疗效分析 |
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| Correlation analysis of the effect of postoperative drainage on surgical efficacy of thoracolumbar fractures through multifidus interspace approach |
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ABSTRACT
Objective To investigate correlation of the effect factors on surgical efficacythe of whether postoperative drainage through the multifidus interspace approach in the treatment of thoracolumbar fractures.
Methods A total of 66 patients with thoracolumbar fractures admitted from January 2017 to December 2021 were retrospectively analyzed. According to whether postoperative drainage,36 patients were in drainage group and 30 patients were in no drainage group. In the drainage group,there were 17 males and 19 females with an average age of (55.4±9.5) years old ranging from 23 to 68 years old;in the no drainage group,there were 16 males and 14 females with an average age of (53.9±8.3) years ranging from 30 to 69 years old. A multifidus interspace approach was used in both groups. Then factores of age,gender,fracture site,injured segment,operation time,intraoperative blood loss,preoperative Cobb angle,preoperative vertebral anterior height ratio,preoperative Japanese 0rthopaedic Association(J0A) score,preoperative visual ana1ogue scale(VAS),preoperative Oswestry Disability Index(ODI) score may affect the postoperative drainage,using univariate and multivariate Logistic regression analysis to study their influence on the prognosis. The postoperative Cobb angle,anterior vertebral height ratio,JOA score,VAS and ODI were compared between the two groups.
Results Univariate analysis showed that whether postoperative drainage may be related to patient age,whether injury to multiple segments,operation time,and intraoperative blood loss(P<0.05). The multivariate analysis showed that age,operation time were the main factors affecting postoperative drainage(P<0.05). There was no significant difference in Cobb angle,anterior vertebral height loss rate,JOA score,VAS score and ODI score between the two groups at the postoperative follow-up(P>0.05). In terms of complications,the total incidence of postoperative low back pain in the no drainage group was lower than that in the drainage group(P<0.05). There was no significant difference in postoperative infection and postoperative nerve loss between the two groups(P>0.05).
Conclusion Age and operation time are the main factors affecting the postoperative drainage through multifidus interspace approach for thoracolumbar fractures. And no drainage does not affect the long-term effect of the operation,on the contrary,no drainage can reduce the method of low back pain and obtain more benefits. |
| KEY WORDS Multifidus interspace approach Thoracolumbar fractures Postoperative drainage Efficacy analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 白凡,王凌挺.经多裂肌间隙入路治疗胸腰段骨折术后引流对手术疗效影响的相关性分析[J].中国骨伤,2024,37(11):1062~1068 |
| 英文格式: | BAI Fan,WANG Ling-ting.Correlation analysis of the effect of postoperative drainage on surgical efficacy of thoracolumbar fractures through multifidus interspace approach[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(11):1062~1068 |
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