颅骨牵引复位配合颈前路减压融合术治疗下颈椎骨折脱位合并关节突绞锁的临床研究

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摘要目的探讨颅骨牵引复位配合颈前路减压融合术治疗下颈椎骨折脱位合并关节突绞锁的临床效果。方法选取解放军总医院第八医学中心2015年1月～2018年1月收治的下颈椎骨折脱位合并关节突绞锁患者96例，根据随机数字表法将所有患者分为对照组和研究组，每组各48例。研究组给予颅骨牵引复位配合颈前路减压融合术治疗，对照组给予前路撑开撬拨复位固定，比较两组患者临床疗效、患者恢复情况、脊髓神经功能、围术期指标，记录两组术后并发症发生情况。结果研究组总有效率明显高于对照组（P ＜ 0.05）。两组术后1年感觉功能、运动功能评分均升高，且研究组高于对照组（P ＜ 0.05）。研究组手术时间短于对照组，术中出血量少于对照组（P ＜ 0.05）。研究组术后美国脊髓损伤协会（ASIA）分级评分高于对照组（P ＜ 0.05）。研究组并发症发生率显著低于对照组（P ＜ 0.05）。结论下颈椎骨折脱位合并关节突绞锁患者经颅骨牵引复位配合颈前路减压融合术治疗效果显著，可有效改善脊髓神经功能，降低并发症的发生。

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	简伟吴广森隰建成才晓军陈兴王永川

关键词 ：颅骨牵引复位, 颈前路减压融合术, 下颈椎骨折脱位合并关节突绞锁, 临床研究

Abstract：Objective To investigate the clinical effect of cranial traction reduction combined with anterior cervical decompression and fusion in the treatment of lower cervical spine fracture and dislocation combined with articular process interlocking. Methods A total of 96 patients with fracture and dislocation of the lower cervical vertebra combined with articular process lock admitted to the 8th Medical Center of PLA General Hospital from January 2015 to January 2018 were selected. According to the random number table method, all patients were divided into control group and study group with, 48 cases in each group. The study group was treated with skull traction reduction combined with anterior cervical decompression and fusion, while the control group was treated with anterior pry and fixation. The clinical efficacy, patient recovery, spinal cord nerve function and perioperative indexes of the two groups were compared, and postoperative complications of the two groups were recorded. Results The total effective rate of the study group was significantly higher than that of the control group (P ＜ 0.05). The scores of sensory function and motor function in the two groups increased one year after operation, and the score in the study group were higher than those in the control group (P ＜ 0.05). The operation time of the study group was shorter than that of the control group, and the amount of bleeding during the operation was less than that of the control group (P ＜ 0.05). The improvement of American spinal cord injury association (ASIA) grading of the study group was significantly better than that of the control group (P ＜ 0.05). The incidence of complications in the study group was significantly lower than that in the control group (P ＜ 0.05). Conclusion The curative effect of cranial traction reduction combined with anterior cervical decompression and fusion in treatment of lower cervical spine fracture and dislocation combined with articular process interlocking is remarkable, it can effectively improve the spinal nerve function, and reduce the incidence of complications.

Key words： Cranial traction reduction Anterior cervical decompression and fusion Lower cervical spine fracture and dislocation combined with articular process interlocking Clinical study

基金资助:北京市科技计划项目（Z151100003117026）。

引用本文:

简伟吴广森隰建成才晓军陈兴王永川. 颅骨牵引复位配合颈前路减压融合术治疗下颈椎骨折脱位合并关节突绞锁的临床研究[J]. 中国医药导报, 2019, 16(36): 85-88.
JIAN Wei WU Guangseng XI Jiancheng CAI Xiaojun CHEN Xing WANG Yongchuan. Clinical study of cranial traction reduction combined with anterior cervical decompression and fusion in the treatment of lower cervical spine fracture and dislocation combined with articular process interlocking. 中国医药导报, 2019, 16(36): 85-88.

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