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目的探讨低龄先天性脊柱侧弯手术治疗方法。方法低龄先天性脊柱侧弯患儿27例,依据手术方法分为2组,观察组14例行经后路半椎体切除手术,对照组13例行经后路半椎体切除+椎弓根螺钉内固定术,比较2组手术时间、术中出血量以及手术前、后冠状位主弯Cobb角和术后侧弯矫正情况。结果 (1)观察组手术时间[(173.86±50.06)min]、术中出血量[(76.14±28.61)mL]低于对照组[(262.69±48.30)min、(382.14±27.63)mL],2组比较差异有统计学意义(P<0.05);(2)观察组术前冠状位主弯Cobb角[(36.74±9.08)°]与对照组[(39.37±7.63)°]比较差异无统计学意义(P>0.05),2组术后冠状位主弯Cobb角[(20.37±3.61)°、(15.48±3.07)°]均较术前降低(P<0.05);观察组末次随访时冠状位主弯相应矫正率[(39.04±13.8)%]低于对照组[(51.68±11.82)%](P<0.05)。结论对合并脊髓畸形、需早期手术的低龄先天性脊柱侧弯患儿,单纯半椎体切除手术创伤小,是一种可行的治疗方法;但后路半椎体切除+椎弓根螺钉内固定对矫正和控制先天性脊柱侧弯畸形效果更好。
Objective To investigate the surgical treatment of congenital scoliosis in young patients. Methods 27 cases of children with congenital scoliosis were divided into 2 groups according to the operation method and 14 cases in the observation group were treated by posterior hemivertebra resection and 13 cases in the control group were treated by posterior hemivertebra resection + pedicle Screw fixation was performed to compare the operation time, blood loss, corneal primary Cobb angle and postoperative flexion before and after surgery. Results (1) The operation time in the observation group was (173.86 ± 50.06) min and the intraoperative blood loss was (76.14 ± 28.61) mL lower than that in the control group (262.69 ± 48.30 min, 382.14 ± 27.63 mL, 2 (P <0.05). (2) There was no significant difference in Cobb angle of the main coronal coronary angiography before surgery in the observation group [(36.74 ± 9.08) ° vs [39.37 ± 7.63 °] in the control group (P <0.05). The Cobb angle of the main coronaries [(20.37 ± 3.61) °, (15.48 ± 3.07) °] in the two groups were significantly lower than those before the operation (P <0.05) The corresponding correction rate of the main curve (39.04 ± 13.8%) was lower than that of the control group (51.68 ± 11.82%) (P <0.05). Conclusions In children with congenital spinal cord deformity who require early operation and congenital scoliosis at the younger age, simple traumatic hemispheric resection is a feasible treatment. However, posterior hemivertebra resection and pedicle screw fixation The correction and control of congenital scoliosis deformity better.