| 黄凤琪,甘荣坤,韦 超,王剑敏,李小荣.经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折的疗效及对患者氧化应激与术后疼痛的影响[J].,2022,(7):1267-1271 |
| 经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折的疗效及对患者氧化应激与术后疼痛的影响 |
| The Effects of Percutaneous Pedicle Screw Fixation in the Treatment of Thoracolumbar Spine Fractures and Its Influence on Patients' Oxidative Stress and Postoperative Pain |
| 投稿时间：2021-09-19 修订日期：2021-10-15 |
| DOI：10.13241/j.cnki.pmb.2022.07.015 |
| 中文关键词: 经皮穿刺椎弓根螺钉内固定 胸腰段脊柱骨折 氧化应激 术后疼痛 |
| 英文关键词: Percutaneous pedicle screw fixation Thoracolumbar spine fracture Oxidative stress Postoperation pain |
| 基金项目:福建省卫生厅青年科研课题(201864432) |
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| 中文摘要: |
| 摘要 目的：探讨经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折的疗效及对患者氧化应激及术后疼痛的影响。方法：选取本院2017年4月到2021年4月在本院诊治的胸腰段脊柱骨折患者126例作为研究对象，依据手术方式的不同将其分为微创组与开放组各63例。微创组给予经皮穿刺椎弓根螺钉内固定治疗，开放组给予开放式椎弓根内固定术治疗。结果：微创组的切口长度等围手术指标均少于开放组（P<0.05）；微创组术后1 d、3 d、5 d与7 d的疼痛视觉模拟评分（VAS）低于开放组（P<0.05）；微创组术后7 d的的感染、切口愈合不良、内固定移位、神经根脊髓压迫等并发症发生率为3.2 %，低于开放组的22.2 %（P<0.05）；两组术后7 d的血清P物质（SP），和β-内啡肽（β-EP）含量高于术前1 d，微创组高于对照组（P<0.05）；两组术后7 d的血清谷胱甘肽过氧化物酶（GSH-Px）与晚期氧化蛋白产物（AOPP）含量高于术前1 d，微创组高于开放组（P<0.05）。结论：经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折可有效控制氧化应激指标、疼痛介质水平，减少创伤，减轻术后疼痛，降低并发症，有利于患者康复。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of percutaneous pedicle screw internal fixation in the treatment of thoracolumbar spine fractures and its influence on patients' oxidative stress and postoperative pain. Methods: A total of 126 patients with thoracolumbar spinal fractures treated in our hospital from April 2017 to April 2021 were selected as the research subjects. According to different surgical methods, the patients were divided into minimally invasive group and open group, 63 patients in each group. Minimally invasive group was treated with percutaneous pedicle screw internal fixation, and open group was treated with open pedicle internal fixation. Results: The incision length and other perioperative indexes in the minimally invasive group were less than those in the open group (P<0.05). The VAS of pain in the Minimally invasive group at 1 d, 3 d, 5 d and 7 d after operation were lower than that of the open group (P<0.05). The incidence of complications such as infection, poor incision healing, internal fixation displacement, and nerve root and spinal cord compression in the minimally invasive group at 7 d after surgery were 3.2%, which were lower than 22.2% in the open group (P<0.05). The serum Substance P (SP) and β-endorphin (β-EP) levels in the two groups at 7 d after surgery were higher than those on the 1 day before operation, and the minimally invasive group were higher than the control group (P<0.05). The levels of serum glutathione peroxidase (GSH-Px) and Advanced Oxidized Protein Products (AOPP) on the 7th day after operation in the two groups were higher than those on the 1 day before operation, the minimally invasive group were higher than the open group (P<0.05). Conclusion: Percutaneous pedicle screw internal fixation for thoracolumbar spinal fracture can effectively control oxidative stress index and pain medium level, reduce trauma, relieve postoperative pain, reduce complications, and benefit patients' recovery. |
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