李学颖

【摘要】 目的：探究非椎板減压椎弓根螺钉撑开复位治疗腰椎爆裂性骨折的效果及对机体创伤应激的影响。方法：选取2017年12月-2019年10月收治的80例腰椎爆裂性骨折患者为研究对象，将其随机分为对照组（采取椎板减压治疗）和观察组（采取非椎板减压椎弓根螺钉撑开复位），每组40例。比较两组的术中出血量、手术时间和手术前后的椎体参数、神经损伤相关指标及创伤应激指标。结果：观察组的术中出血量显著少于对照组，手术时间显著短于对照组，差异均有统计学意义（P<0.05）。术前，两组的椎体参数、神经损伤相关指标及创伤应激指标比较，差异均无统计学意义（P>0.05）;术后6、12周，两组的椎体参数及神经损伤相关指标比较，差异均无统计学意义（P>0.05）;术后3、7 d，观察组的创伤应激指标均显著低于对照组，差异均有统计学意义（P<0.05）。结论：非椎板减压椎弓根螺钉撑开复位在腰椎爆裂性骨折中的应用效果较好，且对机体创伤应激的影响相对更小，临床价值较高。

【关键词】 非椎板减压椎弓根螺钉撑开复位 腰椎爆裂性骨折 机体创伤应激

[Abstract] Objective： To investigate the effect of distraction reduction of pedicle screw without laminectomy in the patients with lumbar burst fracture and influence for body traumatic stress. Method： A total of 40 patients with lumbar burst fracture from December 2017 to October 2019 were chosen as the study objects， and they were randomly divided into control group （laminectomy treatment） and observation group （distraction reduction of pedicle screw without laminectomy）， 40 cases in each group. The blood loss during the operation， operation time， and vertebral body parameters， nerve injury related indexes and traumatic stress indexes before and after the operation of two groups were compared. Result： The blood loss during the operation of observation group was significantly less than that of control group， the operation time was significantly shorter than that of control group， there were statistically significant differences （P<0.05）. The vertebral body parameters， nerve injury related indexes and traumatic stress indexes before the operation of two groups were compared， there were no statistically significant differences （P>0.05）; the vertebral body parameters and nerve injury related indexes of two groups at 6 and 12 weeks after the operation were compared， there were no statistically significant differences （P>0.05）; the traumatic stress indexes of the observation group at 3 and 7 d after the operation were significantly lower than those of control group， there were statistically significant differences （P<0.05）. Conclusion： The effect of distraction reduction of pedicle screw without laminectomy in the patients with lumbar burst fracture has a good effect， and the effect on traumatic stress of the body is relatively small， and the clinical value is high.

[Key words] Distraction reduction of pedicle screw without laminectomy Lumbar burst fracture Body traumatic stress

First-authors address： Rizhao International Heart Hospital， Rizhao 276800， China

doi：10.3969/j.issn.1674-4985.2021.08.004

腰椎爆裂性骨折的危害显著，不仅表现出骨折方面的症状体征，可能对神经功能造成一定不良影响，手术作为本类患者治疗的常见有效手段，与骨折等损伤对患者均可造成显著的创伤应激反应，表现为创伤应激指标的显著升高，而创伤应激程度不仅可反映手术创伤程度[1-2]，还关系到患者术后机体的恢复效果，因此日益受到临床重视。本研究就非椎板减压椎弓根螺钉撑开复位在腰椎爆裂性骨折中的应用效果及对机体创伤应激的影响进行探究，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年12月-2019年10月收治的80例腰椎爆裂性骨折患者为研究对象，将其随机分为对照组和观察组，每组40例。纳入……