肱骨干骨不连翻修手术对患者健康相关生活质量的影响  

Effects of surgical revision for humeral shaft nonunion on health-related quality of life

作　　者：路遥[1] 王志猛 孙亮[1] 王谦[1] 马腾[1] 李明[1] 任程[1] 薛汉中[1] 李忠[1] 张堃[1] Lu Yao;Wang Zhimeng;Sun Liang;Wang Qian;Ma Teng;Li Ming;Ren Cheng;Xue Hanzhong;Li Zhong;Zhang Kun(Department of Orthopaedics and Traumatology,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院创伤骨科下肢病区,710054

出　　处：《中华创伤骨科杂志》2020年第5期394-399,共6页Chinese Journal of Orthopaedic Trauma

基　　金：陕西省自然科学基金(2019JQ-976)。

摘　　要：目的探讨肱骨干骨不连翻修手术对患者健康相关生活质量的影响。方法回顾性分析自2013年3月至2018年9月西安交通大学附属红会医院创伤骨科下肢病区采用翻修手术治疗的62例肱骨干骨不连患者资料。男43例,女19例;年龄20~73岁,平均42.3岁。骨不连类型:萎缩型19例,缺血型14例,肥大型29例。记录并分析患者人口统计学数据、临床数据、影像学表现和治疗方法。并通过健康调查12条简表(SF-12)和简明疼痛度量表(BPI)评价肱骨干骨不连患者的健康相关生活质量,并采用Mayo肘关节功能评分(MEPS)评估患者肘关节功能。结果入院时患者SF-12中的生理总评分(PCS)评分为(24.3±5.2)分,SF-12中的心理总评分(MCS)评分为(26.3±3.8)分,BPI中的中严重程度(BPI-S)评分为(6.5±1.9)分,BPI中的疼痛干扰(BPI-I)评分为(6.7±2.5)分。术后1年随访时,PCS评分平均(43.6±8.1)分,MCS评分平均(34.7±4.4)分,BPI-S平均(4.9±1.2)分,BPI-I平均(4.4±1.4)分。以上四组指标术前与术后1年比较差异均有统计学意义(P<0.05)。末次随访时根据MEPS标准,肘关节功能优良率为95.2%(59/62)。通过与文献数据比较,肱骨干骨不连患者术后PCS评分与Barrentt食管、原发性高血压、慢性阻塞性肺疾病和硅肺患者的PCS评分比较差异均无统计学意义(P>0.05),术后MCS与脑卒中患者MCS评分比较差异无统计学意义(P>0.05)。结论肱骨干骨不连是一种破坏性的慢性疾病,对身心健康和生活质量都有负面影响。虽然对肢体疼痛的影响可以通过翻修手术来缓解,但整个治疗过程可能会对患者造成永久的心理创伤。Objective To investigate the effects of surgical revision for humeral shaft nonunion on health-related quality of life.Methods The data of 62 patients were studied retrospectively who had been hospitalized at Department of Orthopaedics and Traumatology,Hong-Hui Hospital for humeral shaft nonunion from March 2013 to September 2018.They were 43 males and 19 females,aged from 20 to 73 years(average,42.3 years).Their nonunions belonged to the atrophic type in 19 cases,to the ischemic type in 14 cases and to the hypertrophic type in 29 cases.Their demographic and clinical data,imaging manifestations and treatment methods were recorded and analyzed.The 12-item short form health survey(SF-12)and brief pain inventory(BPI)were used to evaluate their health-related quality of life and the Mayo elbow performance score(MEPS)was used to evaluate their elbow function.Results Upon admission,their physical component summary(PCS)scored 24.3±5.2,mental component summary(MCS)26.3±3.8,brief pain inventory-severity(BPI-S)6.5±1.9,and brief pain inventory-interference(BPI-I)6.7±2.5.At 1-year follow-up,their PCS averaged 43.6±8.1,MCS 34.7±4.4,BPI-S 4.9±1.2,and BPI-I 4.4±1.4.There were statistically significant differences between preoperation and postoperation in the above 4 groups of indicators(P<0.05).Their MEPS at the last follow-up revealed a 95.2%rate of excellent elbow function(59/62).By comparison with the literature data,their postoperative PCS scores were not significantly different from those for the patients with Barrentt's esophagus,primary hypertension,chronic obstructive pulmonary disease and silicosis(P>0.05).There was no significant difference either in the postoperative MCS scores between them and stroke patients(P>0.05).Conclusions As a destructive chronic disease,humeral shaft nonunion has negative effects on physical and mental health and quality of life of the patients.Although the pain effect on the limb can be alleviated by surgical revision,the entire treatment may cause permanent psychological trauma to

关 键 词：肱骨 骨折 不愈合 生活质量 SF-12量表 BPI量表 

分 类 号：R687[医药卫生—骨科学]