汤志坚+刘小勇+肖蝉+刘凡汝+王芳

摘 要 目的：探讨注射硫酸钙在胸腰椎骨折微创内固定治疗中的应用价值。方法：选择胸腰椎骨折患者40例，依据治疗方法分为观察组（注射硫酸钙联合微创内固定治疗）和对照组（常规微创内固定治疗）各20例，采用Oswestry功能障碍指数（Oswestry disability index，ODI）评估患者功能障碍情况，随访6个月，统计分析所有患者填充物注射量、住院时间、术后可下床活动时间和术前1 d、术后1 d、1、3、6个月Cobb角、椎体前缘高度情况及术前、术后ODI。结果：观察组患者填充物注射量明显高于对照组、而住院时间、术后可下床活动时间、术后1 d、1、3、6个月Cobb角、椎体前缘高度压缩率、术后ODI值明显低于对照组（P<0.05）。结论：注射硫酸钙联合微创内固定可有效提高治疗胸腰椎骨折过程中的椎体稳定性和减少Cobb角丢失，有利于改善功能障碍，进而加快患者身体的恢复，值得临床进一步实践。

关键词 硫酸钙 胸腰椎骨折 微创内固定 功能障碍

中图分类号：R982； R683.1 文献标识码：B 文章编号：1006-1533（2016）19-0041-04

Application of the injection of calcium sulfate combined with minimally invasive internal fixation in the treatment of 20 cases of patients with thoracolumbar fractures*

TANG Zhijian1**， LIU Xiaoyong1， XIAO Chan1， LIU Fanru1， WANG Fang2（1. Chinese Medicine Hospital of Yongxin County， Jian 343000， China； 2. Community Health Service Center of Huaizhong Town in Yongxin County， Jian 343000， China）

ABSTRACT Objective： To discuss the value of the application of the injection of calcium sulfate combined with minimally invasive internal fixation in the patients with thoracolumbar fractures. Methods： Forty patients with thoracolumbar fractures were selected and randomly divided into an observation group （receiving injectable calcium sulfate in combination with minimally invasive internal fixation） and a control group （receiving only minimally invasive internal fixation） with 20 cases each according to the method for their treatment. The dysfunction degree of patients was assessed by the Oswestry disability index （ODI） and all the patients were followed up for six months. Injection volume of filler， length of hospital stay， postoperative ambulation time， Cobb angle and the height of anterior vertebrae and preoperative and postoperative ODI were statistically analyzed. Results： Injection volume of filler was obviously bigger in the observation group than in the control group while the hospital stay time and postoperative ambulation time were significantly shorter and the preoperative ODI， Cobb angle and the compression rate of the height of anterior vertebrae after 1， 3， 6 months observation were significantly less or lower in the observation group. Conclusion： Calcium sulfate injection therapy combined with the minimally invasive internal fixation can effectively improve vertebral stability and reduce the loss of Cobb angle， which is of benefit to promoting fracture healing， improving dysfunction and accelerating the recovery of patients and worthy of further clinical practice.

KEY WORDS calcium sulfate； thoracolumbar fractures； minimally invasive internal fixation； dysfunction

胸腰椎骨折是临床上常见的躯干骨折之一，是由高能量作用于胸腰椎骨质造成连续性破坏所致，可导致骨折部位剧烈疼痛、后躯干及双下肢感觉麻木、多项运动功能障碍等，严重影响患者的正常生活[1]。目前，胸腰椎骨折多采用手术治疗，可通过手法和填充物（植骨材料）注入有效地对受创椎体进行复位及稳定，但临床上植骨材料有多种，不同材料间的效果具有较为明显的差异。因此，选择效果更为良好的植骨材料对提高胸腰椎骨折的临床疗效具有重要的价值。对此，本研究通过给予患者注射硫酸钙联合微创内固定治疗，探讨其在胸腰椎骨折微创内固定治疗中的应用价值。

1 资料与方法

1.1 一般……