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[1]陳海龍,鄭九琴,朱文瀟,等.常規(guī)顱骨牽引和全身麻醉下手法復位在下頸椎脫位前路減壓植骨融合內(nèi)固定術中的應用[J].中醫(yī)正骨,2017,29(07):74-76,79.
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常規(guī)顱骨牽引和全身麻醉下手法復位在下頸椎脫位前路減壓植骨融合內(nèi)固定術中的應用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年07期
頁碼:
74-76,79
欄目:
臨床報道
出版日期:
2017-07-20

文章信息/Info

作者:
陳海龍鄭九琴朱文瀟馬俊杰張紅星
河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽 471002
關鍵詞:
頸椎 脫位 牽引術 正骨手法 麻醉全身
摘要:
目的:探討常規(guī)顱骨牽引和全身麻醉下手法復位在下頸椎脫位前路減壓植骨融合內(nèi)固定術中的作用及安全性。方法:2014年5月至2016年3月,對行前路減壓植骨融合內(nèi)固定術的26例新鮮下頸椎脫位患者,采用常規(guī)顱骨牽引和全身麻醉下手法復位; 男17例,女9例; 年齡21~75歲,中位數(shù)48歲; C4~C5脫位7例、C5~C6脫位14例、C6~C7脫位5例; 單純脫位20例,脫位伴骨折6例; 雙側關節(jié)突關節(jié)交鎖19例,單側關節(jié)突關節(jié)交鎖7例; 根據(jù)脊髓損傷的Frankel分級,A級5例、B級7例、C級9例、D級4例、E級1例。受傷至就診時間4~28 h,中位數(shù)19 h。術后隨訪觀察椎體復位、植骨融合、椎間高度恢復、并發(fā)癥發(fā)生及脊髓功能恢復情況。結果:所有患者均獲隨訪,隨訪時間4~24個月,中位數(shù)12個月; 椎體均復位良好,植骨均獲得骨性融合,椎間高度均得以恢復; 均無血管損傷、氣管損傷、食管損傷、脊髓損傷、椎體再脫位及螺釘松動、斷裂等并發(fā)癥發(fā)生。脊髓神經(jīng)功能Frankel分級A級5例、B級5例、C級5例、D級6例、E級5例。結論:行前路減壓植骨融合內(nèi)固定術治療下頸椎脫位前,采用常規(guī)顱骨牽引和全身麻醉下手法復位,創(chuàng)傷小,可實現(xiàn)頸椎即時復位,且復位成功率高,椎間植骨融合率高,能恢復椎間高度,有利于脊髓神經(jīng)功能的恢復,并發(fā)癥少,值得臨床推廣使用。

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更新日期/Last Update: 2017-12-29