多轴向钉.docxVIP

多轴向钉 作者：李孟军，吉旭彬，许海宁，闫新海，褚秀成 【摘要】 目的 总结应用多轴向钉-棒系统治疗脊椎转移瘤的经验、技术要点及临床效果。为治疗脊椎转移瘤提高疗效、缩短治疗时间、减少并发症、提高患者的生活质量探讨一种新而有效的手术方法。方法 将应用多轴向钉-棒系统固定融合手术治疗的脊椎转移瘤患者的住院和随访资料进行系统分析，与传统手术方法比较，进行资料对比研究和统计分析。结果 应用NCSS统计软件统计分析，发现治疗组患者术后卧床时间显著短于对照组（Plt;0.05），1年生存率显著大于对照组（Plt;0.05），而3年生存率与对照组比较差异无显著性（χ2=0.0421，Pgt;0.05），固定失败（包括断钉、断棒、钉子松动、拔出、钉棒松开、水泥脱出等）发生率明显低于对照组（Plt;0.05），手术期并发症（刀口感染、褥疮、泌尿系统感染、肺部感染等）发生率明显低于对照组（Plt;0.05），而所用平均手术时间差异无显著性（Pgt;0.05）。结论 应用多轴向钉-棒系统治疗脊柱转移瘤不但手术操作方便、固定可靠、术后可以及早下床活动，有利于进行其他治疗措施，提高患者生活质量。 【关键词】 多轴向钉-棒系统；脊椎；转移瘤；外科学 【Abstract】 Objective To describe the technique and the initial clinical and radiographic results for the use of a new implant system as poly-axial screw and rod system in the treatment of vertebral tumor metastasis，and sum up the experience of using this new technique key points，complications etc.Methods Summarized of the background data.Compared the control group (46 cases) with fixation by screws traditional CD，plate and screws，and the treating group (38 cases treated from Feb.1998 to Feb.2004) with poly-axial screws and rods system was described.Results All the data was processed with the NCSS statistical software.The mean time that patients should stay in bed of control-group was significantly less than the observing group.Live rate of control-group in 1 year was significantly higher than the observing group (Plt;0.05)，but no significant difference was found about the 3-year-live rate (Pgt;0.05).The failed fixation (include fracture or lose of the rod and screws，motion of screws and cement.) and the complication rate that connected with operation in the observing group were significantly more found than the control group (Plt;0.05).No significant difference was found about the mean time of operation between the observing group and the control group(Pgt;0.05).Conclusion Fixation with poly-axial screw-rod system seems to be a reliable，safe，effective and simple technique and should be considered an efficient alternative to the