MIPPO技术治疗骨盆前环不稳定型骨折患者的临床观察  

INVISTIGATION ON THE EFFECT OF MIPPO TECHNOLOGY ON THE UNSTABLE FRACTURE OF PELVIC ANTERIOR RING

作　　者：邹菁[1] 武明鑫[1] 陈敏[1] Zou Jing Wu Mingxin Chen Min(Department of Section 1 Orthopaedics, The Third People＇s Hospital of Huizhou City,516000 Huizhou, China)

机构地区：[1]广东省惠州市第三人民医院骨一科,惠州516000

出　　处：《广西医科大学学报》2016年第3期455-459,共5页Journal of Guangxi Medical University

基　　金：广东省惠州市科技计划资助项目(No.20150802)

摘　　要：目的:探讨微创经皮钢板内固定(MIPPO)技术治疗骨盆前环不稳定型骨折患者的临床效果及对Majeed功能评分、深下肢静脉血栓(DVT)和血清炎性因子水平的影响。方法:选取2015年5月至2015年10月广东省惠州市第三人民医院骨一科收治的骨盆前环不稳定型骨折患者66例,按随机数字表法分为实验组(n=33)和对照组(n=33)。实验组采用MIPPO技术进行固定治疗,对照组行改良Stoppa入路重建钢板固定治疗。比较两组手术情况、术后1个月和术后3个月的Majeed功能评分及DVT发生率、围术期血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和血浆C反应蛋白(CRP)水平及不良反应和并发症发生情况。结果:与对照组比较,实验组手术时间延长,实验组术中出血量减少,实验组骨折愈合时间和术后住院时间缩短,实验组术后1个月和术后3个月的Majeed功能评分提高,实验组DVT发生率和伤口感染发生、血管神经损伤发生等不良反应和并发症总发生率均降低(均P<0.05)。与术前比较,实验组和对照组术后3d和1周的血清IL-6和TNF-α水平及血浆CRP水平均降低;与对照组比较,实验组术后3d和1周的血清IL-6和TNF-α水平及血浆CRP水平均降低(均P<0.05)。结论:MIPPO技术应用于骨盆前环不稳定型骨折的术中出血量少,术后恢复快,可有效改善患者的生存质量,控制炎症反应并减少术后不良反应和并发症的发生,具有良好的可行性和安全性,值得临床推广应用。Objective：To investigate the effect of minimally invasive percutaneous plate osteosynthesis（MIPPO）technology on the unstable fracture of pelvic anterior ring,by evaluations on the Majeed function score,deep vein thrombosis（DVT）of lower extremity,and serum inflammatory cytokines levels.Methods：66cases of patients with unstable fracture of pelvic anterior ring in our hospital from May 2015 to October 2015 were selected and divided into the test group（n =33）and the control group（n =33）.Patients in the test group were treated with MIPPO technique for fixed treatment,and the controls received modified Stoppaapproach line reconstruction plate fixation treatment.Surgery conditions,postoperative 1month and 3months Majeed function score,incidence of DVT,perioperative serum interleukin 6（IL-6）,tumor necrosis factor-α（TNF-α）and plasma C reactive protein（CRP）levels,adverse reaction and complications of two groups were compared.Results：Compared with the control group,the operation time was extended in the test group（P〈0.05）,while the intraoperative blood loss of the test group was reduced（P〈0.05）.The fracture healing time and postoperative duration of hospitalization in the test group was shortened（P〈0.05）.Majeed functional score was increased in the test group after 1month and 3months of operation（P〈0.05）,while the incidences of DVT and wound infection,damage rates of blood vessels and nerve,and overall rates of other adverse reactions and complications were significantly decreased（P〈0.05）.Compared with preoperative levels,the levels of IL-6,TNF-αand CRP in both groups were reduced on postoperative 3dand 1week（P〈0.05）.IL-6,TNF-αand CRP levels in the test group on postoperative 3dand 1week were lower than those in the control group（P〈0.05）.Conclusion：In the treatment of unstable fracture of pelvic anterior ring,MIPPO technique can reduce intraoperative blood loss,promote postoperative recovery and improve the patient＇s survival quality;it also

关 键 词：MIPPO技术 骨盆前环不稳定型骨折 Majeed功能评分 深下肢静脉血栓 炎性因子 

分 类 号：R683.3[医药卫生—骨科学]