高能震波对老年桡骨远端骨折愈合及骨密度的影响  

The Effects of High Energy Shock Waves on the Healing and the Bone Mineral Density of Elders′ Distal Radius Fracture

作　　者：聂玮[1,2] 李晓林[2] 张博[1] 曾炳芳[2] 

机构地区：[1]苏州大学,江苏苏州215000 [2]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《实用骨科杂志》2011年第6期504-509,共6页Journal of Practical Orthopaedics

基　　金：上海市科学技术委员会科研计划资助项目(09411966500)

摘　　要：目的观察高能震波(high energy shock waves,HESW)对老年桡骨远端骨折愈合过程中的作用及其临床意义。方法筛选75例桡骨远端骨折患者,随机分为震波组(37例)和对照组(38例);震波组应用高能震波仪对石膏固定患者进行治疗,对照组单纯石膏固定。观察两组治疗后骨密度值、特定时间内的临床愈合率及骨性愈合率、VAS疼痛评分、Gartland和Werley腕关节评分、PRWE问卷评分等指标。结果两组骨密度值在骨折后第4周无显著性差异(P=0.694),而在骨折后第8周及第12周时震波组BMD值明显高于对照组(P<0.05),且震波组骨折后12周时骨密度值已高于骨折当天水平(P<0.05)。震波组4周临床愈合率、10周骨性愈合率、骨性愈合后VAS评分、Gartland和Werley腕关节功能评价及PRWE问卷评分等指标结果均优于对照组,差异有统计学意义(P<0.05)。结论 HESW能够有效促进老年桡骨远端骨折患者骨折的愈合,防止骨量丢失,预防再骨折及治疗局部骨质疏松,并可预防及治疗关节僵硬及慢性疼痛等一些并发症状,使患者获得更好的功能恢复。Objective The purpose of this study was to evaluate the effect and observe the clinical efficacy of the high energy shock waves treatment on the distal radius fracture of the elders. Methods Seventy five patients with distal radius fracture were selected and randomly divided into two groups：the control group, with 38 patients who were received only the manual reduction and cast immobilization ;the HESW group,with 37 patients who were treated with HESW（0. 5-0.6 mJ/mm^2 energy flux density with 4000 impulses） after the manual reduction and cast immobilization. The rate of clinical healing after four weeks, the rate of bone union after ten weeks, bone mineral density （BMD） during the treatment and the wrist function,PRWE results after bone union were assessed as measurements. Results While the bone mineral density （BMD） values in four weeks between the two groups were not statistically significant（P=0. 694）,but the BMD values of the HESW group were significantly higher （P=0. 05） than the control group at eight weeks/twelve weeks after fractured. And the HESW group＇ BMD values after twelve weeks show sig- nificantly different from that before treatment （P=0.05）. With regard to the rate of clinical healing after four weeks, the rate of bone union after ten weeks,the VAS scores,wrist function scores and PRWE scores,there were significantly different between the two groups. Conclusion HESW,with effective effects on the treatment on the distal radius fracture of the elders,could promote the healing of fractures effectively. It is efficacious against regional osteoporosis ,joint stiffness and persistent pain. Good functional outcomes and the high quality of life could be obtained by the patients.

关 键 词：高能震波 桡骨远端骨折 功能恢复 

分 类 号：R683.41[医药卫生—骨科学]