摘要
目的评价富血小板血浆(PRP)+Wiltse肌间隙入路伤椎置钉内固定对胸腰椎骨折患者白细胞介素-6(IL-6)、丙二醛(MDA)水平的影响。方法104例胸腰椎骨折患者,依据随机数表法分为对照组和观察组,各52例。对照组行Wiltse肌间隙入路伤椎置钉内固定治疗,观察组在对照组手术基础上联合PRP治疗。比较两组手术相关指标,血清相关指标(血清IL-6、MDA),视觉模拟评分法(VAS)评分和Oswestry功能障碍指数(ODI)评分,椎体相关参数(椎体前缘高度、伤椎矢状面Cobb角),并发症发生率。结果两组手术时间进行差异性分析,所得结果无统计学意义(P>0.05);观察组患者术中出血量(80.19±8.14)ml、术后引流量(50.66±4.19)ml、住院时间(9.11±1.88)d均优于对照组的(112.62±10.53)ml、(70.07±6.38)ml、(12.06±2.73)d,组间差异有意义(P<0.05)。治疗后,观察组患者的血清IL-6(2.22±0.31)ng/L、MDA(6.27±1.16)μmol/L均低于对照组的(4.44±0.55)ng/L、(9.51±1.87)μmol/L,组间差异有意义(P<0.05)。两组患者的VAS和ODI评分治疗前进行差异性分析,所得结果无统计学意义(P>0.05);治疗后,观察组患者的VAS评分(2.14±0.34)分和ODI评分(8.05±1.56)分均比对照组的(3.88±0.57)、(12.27±2.42)分更低,组间差异有意义(P<0.05)。治疗前两组椎体相关参数进行差异性分析,所得结果无统计学意义(P>0.05);治疗后,观察组患者的椎体前缘高度(69.94±6.92)mm、伤椎矢状面Cobb角(12.75±1.19)°优于对照组的(50.55±5.15)mm、(17.66±2.44)°,组间差异有意义(P<0.05)。观察组患者治疗期间的并发症发生率比对照组低(3.85%vs.17.31%),组间差异有意义(P<0.05)。结论PRP联合Wiltse肌间隙入路伤椎置钉内固定治疗胸腰椎骨折,可减少术中创伤,缩短住院时间,有效减轻机体的炎症反应和氧化应激损伤,减轻疼痛,促进椎体功能恢复,且安全性较高,值得临床采纳。
Objective To evaluate the effect of platelet-rich plasma(PRP)+injured vertebra pedicle screw fixation via Wiltse intermuscular approach on the levels of interleukin-6(IL-6)and malondialdehyde(MDA)in patients with thoracolumbar fractures.Methods A total of 104 patients with thoracolumbar fractures were divided into a control group and an observation group according to the principle of random number table,each with 52 cases.The control group received injured vertebra pedicle screw fixation via Wiltse intermuscular approach,while the observation group received combined treatment with PRP on the basis of the control group.Comparison of surgery related indicators,serological related indicators(serum IL-6 and MDA),Visual Analogue Scale(VAS)score,Oswestry Disability Index(ODI),vertebrae-related parameters(anterior vertebral height,sagittal Cobb angle of the injured vertebra),and the incidence of complications between the two groups.Results Difference analysis of the operation time between the two groups showed no statistical significance(P>0.05).The intraoperative blood loss of patients in the observation group was(80.19±8.14)ml,the postoperative drainage volume was(50.66±4.19)ml,and the hospitalization time was(9.11±1.88)d,which were superior to those in the control group[(112.62±10.53)ml,(70.07±6.38)ml,and(12.06±2.73)d],and the differences between the groups were significant(P<0.05).After treatment,the observation group had serum IL-6 of(2.22±0.31)ng/L and MDA of(6.27±1.16)μmol/L,which were lower than those in the control group[(4.44±0.55)ng/L and(9.51±1.87)μmol/L],and the differences between the groups were significant(P<0.05).Differences analysis of VAS and ODI scores between the two groups showed no statistical significance(P>0.05).After treatment,the observation group had VAS score of(2.14±0.34)points and ODI score of(8.05±1.56)points,which were lower than those in the control group[(3.88±0.57)and(12.27±2.42)points],and the differences between the groups were significant(P<0.05).Before treatment,difference analysis of vertebrae-related parameters between the two groups showed no statistical significance(P>0.05).After treatment,the anterior vertebral height,sagittal Cobb angle of the injured vertebra in the observation group were(69.94±6.92)mm and(12.75±1.19)°,which were better than those in the control group[(50.55±5.15)mm and(17.66±2.44)°],and the differences between the groups were significant(P<0.05).The incidence of complications during the treatment period in the observation group was lower than that in the control group(3.85%vs.17.31%),and the difference between the groups was significant(P<0.05).Conclusion The combination of PRP and injured vertebra pedicle screw fixation via Wiltse intermuscular approach for thoracolumbar fractures can reduce intraoperative trauma,shorten hospitalization time,effectively alleviate inflammation and oxidative stress damage in the body,reduce pain,promote vertebral function recovery,and has high safety.It is worthy of clinical adoption.
作者
韩飞
刘瑞宇
HAN Fei;LIU Rui-yu(Department of Orthopedics,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《中国现代药物应用》
2025年第20期1-6,共6页
Chinese Journal of Modern Drug Application
