發(fā)布時(shí)間：2018-06-07 19:02

  本文選題：先天性脊柱側(cè)凸 + 半椎體畸形��； 參考：《福建醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的評價(jià)單一后路“蛋殼”技術(shù)半椎體切除術(shù)治療完全分節(jié)型半椎體所致先天性脊柱側(cè)凸的矯形效果、手術(shù)安全性和并發(fā)癥等情況。方法回顧性分析2010年1月至2015年1月期間,于我院脊柱外科接受單一后路“蛋殼”技術(shù)半椎體切除術(shù)的先天性脊柱側(cè)凸患者18例,其中男性11例,女性7例;手術(shù)時(shí)的平均年齡10.8歲(3-23歲)。所有患者的脊柱側(cè)凸均由完全分節(jié)型半椎體畸形所致。測量并比較術(shù)前、術(shù)后以及隨訪時(shí)脊柱正側(cè)位片上的側(cè)凸Cobb角和后凸Cobb角,評估該術(shù)式的矯形效果。此外,還記錄手術(shù)時(shí)間、術(shù)中出血量、術(shù)后并發(fā)癥等情況。結(jié)果手術(shù)時(shí)長約155-270分鐘,平均228分鐘;術(shù)中出血量約為100-3000ml,平均出血量為850ml。手術(shù)固定融合節(jié)段2-5個(gè),平均為3.3個(gè)節(jié)段。術(shù)后隨訪時(shí)間3-40個(gè)月,平均19個(gè)月。冠狀面上的主側(cè)凸Cobb角由術(shù)前的40.07°矯正至術(shù)后的18.57°,矯形率為53.93%;矢狀面上的節(jié)段性后凸Cobb角由術(shù)前的22.73°矯正至術(shù)后的9.50°,矯形率為58.20%;末次隨訪時(shí),主側(cè)凸Cobb角的平均值為25.53°、節(jié)段性后凸Cobb角的平均值為14.57°,與術(shù)后相比,兩者分別丟失了6.96°和5.07°。18例患者中,2例出現(xiàn)內(nèi)固定相關(guān)并發(fā)癥、1例發(fā)生手術(shù)切口感染。所有患者均未出現(xiàn)神經(jīng)系統(tǒng)并發(fā)癥。結(jié)論完全分節(jié)型半椎體所致先天性脊柱側(cè)凸需要早期手術(shù)治療。單一后路“蛋殼”技術(shù)半椎體切除術(shù)直接去除致畸原因,能有效矯正脊柱冠狀面和矢狀面上的畸形;并且,該術(shù)式并發(fā)癥發(fā)生率低、安全性高,因此它是治療先天性脊柱側(cè)凸安全有效的手術(shù)方式。
[Abstract]:Objective to evaluate the orthopaedic effect, surgical safety and complications of single posterior eggshell hemivertebra resection in the treatment of congenital scoliosis caused by complete segmental hemivertebra. Methods from January 2010 to January 2015, 18 patients with congenital scoliosis underwent single posterior "eggshell" hemivertebra resection in our hospital, including 11 males and 7 females. The mean age at the time of operation was 10.8 years old and 3-23 years old. All patients with scoliosis were caused by complete segmental hemivertebra deformities. The preoperative, postoperative and follow-up Cobb angle of scoliosis was measured and compared with that of kyphosis angle. In addition, the operation time, intraoperative bleeding, postoperative complications were recorded. Results the operative time was 155-270 minutes with an average of 228 minutes, and the blood loss during operation was about 100-3000 ml, and the average bleeding volume was 850 ml. Two to five fusion segments were fixed, with an average of 3.3 segments. The follow-up time was 3-40 months (mean 19 months). The Cobb angle in the coronal plane was corrected from 40.07 擄preoperatively to 18.57 擄postoperatively, the correction rate was 53.93 擄, the correction rate of the segmental Cobb angle on the sagittal plane was 58.20 cm from 22.73 擄preoperatively to 9.50 擄postoperatively. The mean value of Cobb angle of principal scoliosis was 25.53 擄, and that of segmental kyphosis was 14.57 擄. Compared with postoperative, the two patients lost 6.96 擄and 5.07 擄.18 cases respectively, 2 cases had complications related to internal fixation and 1 case had operative incision infection. No neurological complications were found in all patients. Conclusion congenital scoliosis caused by complete segmental hemivertebrae needs early surgical treatment. The single posterior "eggshell" technique can remove the causes of teratogenicity directly, which can effectively correct the coronal and sagittal deformities of the spine, and has low incidence of complications and high safety. Therefore, it is a safe and effective surgical method for the treatment of congenital scoliosis.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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