MIPPO与ORIF治疗胫骨平台骨折的对比研究  

A Comparative Study of MIPPO and ORIF in the Treatment of Tibial Plateau Fractures

作　　者：温洪鹏 韩成龙[1] 钟燕[1] WEN Hongpeng;HAN Chenglong;ZHONG Yan(Lianjiang People’s Hospital,Lianjiang 524400,China;不详)

机构地区：[1]广东省廉江市人民医院,广东廉江524400

出　　处：《中国医学创新》2020年第23期60-64,共5页Medical Innovation of China

摘　　要：目的:比较微创经皮接骨板内固定术(MIPPO)与传统切开复位内固定术(ORIF)治疗胫骨平台骨折的效果。方法:选取2016年7月-2019年7月本院收治的80例胫骨平台骨折患者为研究对象,按照随机数表字法将患者分为研究组与对照组,各40例。对照组采用ORIF治疗,研究组采用MIPPO治疗。比较两组患者围手术期指标(手术时间、切口长度、引流管留置时间、骨折愈合时间);比较两组患者术前及术后3 d的炎性因子指标[C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)]水平;比较两组患者术后1个月内的并发症发生情况;比较两组患者的生活质量[欧洲五维健康量表(EQ-5D)]、膝关节功能(Lysholm膝关节评分)及活动度(被动膝关节外旋角度、被动膝关节屈曲角度)。结果:研究组患者手术时间、切口长度、引流管留置时间、骨折愈合时间均明显短于对照组(P<0.05)。术后3 d,两组患者CRP、IL-1β、IL-8水平均较术前显著升高(P<0.05),而研究组上述指标均明显低于对照组(P<0.05)。术后3个月,研究组患者EQ-5D各项评分均明显高于对照组(P<0.05)。术后3个月,两组患者Lysholm评分均较术前显著升高(P<0.05),且研究组明显高于对照组(P<0.05)。术后3个月,两组患者被动膝关节外旋角度、被动膝关节屈曲角度均较术前显著增大(P<0.05),且研究组均明显大于对照组(P<0.05)。术后1个月内,研究组患者切口感染、创伤性关节炎、术区组织水肿发生率均明显低于对照组(P<0.05)。结论:MIPPO治疗胫骨平台骨折患者可缩短围手术期时间,改善其术后生活质量、膝关节功能及关节活动度,降低患者炎性因子水平及术后并发症发生率。Objective:To compare the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) and traditional open reduction internal fixation (ORIF) in the treatment of tibial plateau fractures.Method:A total of 80 patients with tibial plateau fracture admitted to our hospital from July 2016 to July 2019 were selected as the study objects,and the patients were divided into study group and control group according to the random number table method,with 40 patients in each group.The control group was treated with ORIF and the study group with MIPPO.Perioperative indicators (operation time,incision length,indwelling time of drainage tube,fracture healing time) were compared between the two groups.The levels of inflammatory factors[C-reactive protein (CRP),interleukin-1β (IL-1β),and interleukin-8 (IL-8)]were compared between the two groups before and 3 days after surgery.The complications in 1 month after operation were compared between the two groups.Quality of life (EQ-5D),knee function (Lysholm knee score) and activity (passive knee flexion and passive knee flexion) were compared between the two groups.Result:The operation time,incision length,indwelling time of drainage tube and fracture healing time of the study group were significantly shorter than those of the control group (P<0.05).3 days after surgery,the levels of CRP,IL-1 and IL-8 in both groups were significantly higher than those before surgery (P<0.05),while the above indexes in the study group were significantly lower than those in the control group (P<0.05).3 months after the surgery,EQ-5D scores in the study group were significantly higher than those in the control group (P<0.05).3 months after surgery,Lysholm scores in both groups were significantly higher than those before surgery (P<0.05),and the study group was significantly higher than that of the control group (P<0.05).3 months after the surgery,the passive external rotation angle and passive knee flexion angle of both groups were significantly increased compared with those before the ope

关 键 词：MIPPO ORIF 胫骨平台骨折 炎性因子 生活质量 膝关节功能 

分 类 号：R687.3[医药卫生—骨科学]