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探讨颈椎单节段前路融合术后颈托外固定治疗的有效性研究

To investigate the efficacy of cervical external fixation after cervical single-segment anterior fusion

摘要:

目的 本研究拟探讨单节段颈前路椎间盘切除减压融合术术后是否有佩戴颈托的必要性.方法 采用类实验研究的方法,将本科室同楼层的东西2个病区102例患者采用抽签法分组,将东区分为试验组,西区为对照组.试验组54例,对照组48例,试验组患者术后离床活动时与出院后均不戴颈托,对照组患者术后离床活动时与出院3个月内戴颈托.比较2组的术前、术后3个月、术后6个月的颈功能障碍指数(NDI);术后6个月的椎骨融合情况;术前、术后3个月的生命质量评价量表(SF-36)评分.结果 试验组术后3个月NDI为(20.62 ± 1.94)%,较术前(26.06 ± 2.17)%有明显降低(t=18.32,P<0.01);对照组术后3个月NDI为(21.30 ± 1.87)%,较术前(26.26 ± 2.74)%也有明显降低(t=16.67,P<0.01);试验组术后6个月NDI为(14.97 ± 1.85)%,较术前的(26.06 ± 2.17)%有明显降低(t=31.93,P<0.01);对照组术后6个月NDI为(15.98 ± 1.49)%,较术前也有明显降低(t=24.45,P<0.01);试验组术后3个月SF-36评分为(53.37 ± 9.23)分,比对照组(45.77 ± 8.07)分高,差异有统计学意义(t=4.40,P<0.01).结论 颈托外固定治疗与无颈托外固定治疗相比不会影响术后的治疗效果,且能提高患者的生命质量.

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abstracts:

Objective This study was to investigate the necessity of wearing a cervical collar after single-segment anterior cervical discectomy and decompression. Methods The experimental methods were used to group the two wards in the same department. There were 54 patients in the experimental group and 48 patients in the control group. The patients in the experimental group did not wear the cervical collar during the postoperative outpatient activities and after discharge. The control group patients wore the cervical collar within 3 months after walking and after discharge. The cervical dysfunction index of the two groups before surgery and 3 months after surgery was compared between the two groups; also vertebral fusion at 6 months postoperatively; and SF-36 (Quality of Life Assessment Scale) scores before surgery and 3 months after surgery. Results The NDI of the experimental group was significantly lower than that of the preoperative NDI (20.62%±1.94% vs 26.06%±2.17%) (t=18.32, P<0.01). The NDI of the control group was 3 months after operation compared with the preoperative NDI (21.30 ±% 1.87% vs26.26%±2.74%) also had a significant decrease (t=16.67, P<0.01). The NDI of the experimental group was significantly lower than that of the preoperative NDI (14.97%±1.85%vs26.06%±2.17%) (t=31.93, P<0.01), the NDI of the control group was significantly lower than that of the preoperative NDI (15.98% ± 1.49%vs26.26%±2.74%) at 6 months after operation (t=24.45, P<0.01). The difference was statistically significant. The SF-36 score in the last 3 months was higher than that in the control group (53.37±9.23 vs 45.77±8.07), and the difference was statistically significant (t=4.40, P<0.01). Conclusions Compared with the external fixation without neck and neck, the treatment of cervical external fixation does not affect the postoperative treatment effect, and can improve the quality of life of patients.

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作者: 余群飞 [1] 任英 [1] 方萍萍 [1] 肖宇翔 [1] 许国萍 [1]
栏目名称: 论著
DOI: 10.3760/cma.j.issn.1672-7088.2019.24.005
发布时间: 2019-09-25
基金项目:
浙江省教育厅课题(Y201635833) Fund program: Project of Education Department in Shandong Province
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