切开复位钢板内固定及闭合复位外固定架治疗桡骨远端骨折的疗效成本分析  

Cost-effectiveness Analysis of Closed Reduction Plate Fixation and Open Reduction External Fixation for the Treatment of Distal Radius Fracture

作　　者：李琪[1] 屈媛媛 于洪涛[1] 杨坚[1] LI Qi;QU Yuan-yuan;YU Hong-tao;YANG jian(Orthopedics Center,the First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008;Depart of Respiratiory Medicine,the First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院第一附属医院骨科中心,新疆石河子832008 [2]石河子大学医学院第一附属医院呼吸二科,新疆石河子832008

出　　处：《农垦医学》2020年第1期20-23,共4页Journal of Nongken Medicine

摘　　要：目的:比较切开复位钢板内固定及闭合复位外固定架治疗桡骨远端骨折的疗效及医疗成本,为选择经济有效的治疗方案提供依据。方法:回顾性分析2015年6月至2018年12月由石河子大学医学院第一附属医院骨科中心收治的桡骨远端骨折患者85例,根据手术方式不同分为钢板内固定组45例,随访时间(18.33±7.33)个月;外固定架组40例,随访时间(16.38±5.07)个月;分别记录两组患者手术时间,术后Gartland-Werlery评分、DASH评分,医疗费用,计算成本效果比。结果:85例患者均顺利完成手术操作并如期完成随访。钢板内固定组手术时间为(61.67±10.57)分钟,外固定架组手术时间为(22.63±7.44)分钟,两组差异有统计学意义。最后一次随访钢板内固定组Gartland-Werlery评分优28例,良17例,DASH评分(5.69±3.96)分;外固定支架组Gartland-Werlery评分优32例,良8例,DASH评分(4.91±3.01)分,两组比较差异无统计学意义(P>0.05);总的医疗费用成本效果比显示DASH评分每降低一分,钢板内固定组需要多花费4136.99元,外固定架组需要多花费4051.30元。结论:钢板内固定与闭合复位外固定治疗桡骨远端骨折均具有良好的效果,但闭合复位外固定架技术拥有切口小、手术时间短等优势,可能是一种更为经济的治疗方式。Objective:To compare the cost-effectivenesst of plate fixation and external fixation for treatment of distal radius fracture,and to provide a basis for selecting an economical and effective surgical method.Methods:Eighty-five patients with distal radial fracture treated with palte and external fixation from June 2015 to December 2018 were retrospective analyzes.The plate group(n=45)was followed up for(18.33±7.33)months,and the exernal fixation group(n=40)was followed up for(16.38±5.07)months.The operation time,Gartland-Werely score,DASH score and medical expenses were recorded and compared between the two groups.In addition the cost-effectiveness rate(CER)were calculated and compaed.Results:Eighty-five patients successfully completed the operation and were followed up.The operation time of plate group was(61.67±10.57)minutes,and the external fixation group was(22.63±7.44)minutes.The difference between the two groups was statistically significant.In the plate group,Gartland-Werely score:excellent in 28 cases,good in 17cases.DASH score was(5.69±3.96).In the exteral fixation group,Gartland-Werely score:excellent in 32 cases,good in 8cases.DASH score was(4.91±3.01).There was no significant difference between two groups.In term of CER,one point reduction in DASH score require to pay 4136.99 yuan in the plate group,whereas 4051.30 yuan in another group.Conclusion:Both plate fixation and external fixation do achieve satisfactory effect for distal radius fracture.But the external fixation has the advantages of small incision and spend less time,By contrast,the external fixation might be a more selection.

关 键 词：桡骨远端骨折 钢板内固定 外固定架 成本效益分析 

分 类 号：R687.3[医药卫生—骨科学]