脑外伤合并四肢骨折患者血清生长激素水平变化对骨折愈合的影响  

Effect on the changes of serum growth hormone on fracture healing of fracture patients combined with severe craninocerebral trauma

作　　者：王一民[1] 江正康[1] 黄爱军[1] 邵松玲[1] 马树强[1] 蔡汉周[1] 练晓文[1] 周经颖[1] 黄醒忠[1] 

机构地区：[1]广东医学院附属深圳福田医院,深圳518033

出　　处：《中国实用神经疾病杂志》2012年第16期1-3,共3页Chinese Journal of Practical Nervous Diseases

基　　金：深圳市科技计划项目;项目编号:201003239

摘　　要：目的通过动态检测重度颅脑外伤合并四肢骨折及单纯四肢骨折患者血清生长激素(GH)水平的变化,结合骨折愈合时间的改变,探讨内源性生长激素(GH)对骨折愈合的相关性及其影响,为重度颅脑外伤合并四肢骨折患者手术时机的选择和外源性生长激素(rhGH)辅助治疗骨折提供依据。方法 2010-03—2012-03选择重度颅外伤(GCS评分5～8分)合并四肢骨折患者和单纯四肢骨折患者各22例,分别于创伤后1d、3d、7d、9d、14d测定血清GH水平。对2组各时间点GH水平变化进行统计学分析。结果重度脑外伤合并四肢骨折组生长激素水平升高从第3天开始,7d达高峰,9d后开始下降,14d2组水平接近。而单纯四肢骨折各时间点GH水平基本与正常人指标一致。2组在3、7、9dGH水平具有统计学意义(P<0.05)。结论重度颅脑创伤合并四肢骨折患者2周内GH水平升高较对照组明显;与骨痂机化形成期时间一致。因此,对有手术指征的四肢骨折患者在脑部情况稳定后应尽早行骨折手术,依据GH升高时间,骨折手术应尽量在2周内进行。同时,我们推断重组人生长激素(rhGH)的小剂量、短时间应用可能对骨折愈合有促进作用。Objective To dynamically detect the changes of growth hormone （GH） in patients suffered from severe crani- nocerebral trauma with extremities fractures and simple extremities fractures, and discuss the effect of GH on the healing of fracture, to provide the choice of operation timing. Methods From March 2010 to March 2012,22 cases in the two groups re- spectively }oined the observation. Group A suffered from severe craninocerebral trauma （GCS 5~8） with extremities fractures and group B suffered from simple extremities fractures. The GH level of serum was detected at 1st, 3rd, 7th, 9th and 14th day respectively, the results were analyzed statistically. Results Compared with group B, the GH level of group A rose at 3rd day and rose to the peak at 7th day, descended at 9th day and gradually to normal at 14th day. The level of GH in Group B was normal all the time. There was statistical significance at 3rd, 7th and 9th day. Conclusion The level of GH in severe craninoe- erebral trauma with extremities fractures group rose compared with that of control group in two weeks, coincidence with the formation of early callus. Hence, fracture operation should be performed in two weeks in group A if the general conditiond is stable. We may refer that a small dosage of rhGH could promote the healing of fracture.

关 键 词：颅脑损伤 四肢骨折 生长激素 

分 类 号：R651.15[医药卫生—外科学] R683.4[医药卫生—临床医学]