不同钢板内固定技术对胫骨平台骨折患者血清SP NPY水平及膝关节功能的影响  

Effects of Different Plate Internal Fixation Techniques on Serum SP,NPY Levels and Knee Joint Function in Patients with Tibial Plateau Fractures

作　　者：张鹏贵[1] 刘烈东 董建彬 苏海卿[1] ZHANG Penggui;LIU Liedong;DONG Jianbin(Yulin First Hospital, Shaanxi Yulin 719000, China)

机构地区：[1]陕西省榆林市第一医院骨科,陕西榆林719000

出　　处：《河北医学》2020年第9期1473-1478,共6页Hebei Medicine

基　　金：陕西省重点研发计划项目,(编号:2017SF-061)。

摘　　要：目的:探讨不同钢板内固定技术对胫骨平台骨折患者血清P物质(SP)、神经肽(NPY)水平及膝关节功能的影响。方法:选取2017年1月至2018年9月我院74例胫骨平台骨折患者进行前瞻性研究,随机数字表法简单随机分组,各37例。A组行微创内固定系统(LISS)钢板技术,B组行解剖钢板内固定技术。统计对比手术相关指标、并发症发生率、围术期疼痛应激(血清SP、NPY)、术后3个月、6个月、12个月内翻角、后倾角、膝关节活动度及膝关节功能恢复优良率。结果:A组手术时间、术中出血量、术后引流量低于B组,切口长度短于B组(P<0.05);A组术后1、3、7d血清SP、NPY水平低于B组(P<0.05);两组术后3、6、12个月内翻角、后倾角、膝关节活动度比较,差异无统计学意义(P>0.05);A组膝关节功能恢复优良率(81.08%)与B组(78.38%)比较,差异无统计学意义(P>0.05);A组并发症发生率与B组比较,差异无统计学意义(P>0.05)。结论:解剖钢板内固定技术、LISS钢板内固定技术安全性高,膝关节功能恢复良好,但与解剖钢板内固定技术比较,LISS钢板内固定技术切口较短,能明显减少胫骨平台骨折患者术中出血量,降低术后疼痛应激反应,加快术后康复进程,具有较高临床推广价值。Objective To investigate the effects of different plate internal fixation techniques on serum substance P(SP),neuropeptide(NPY)levels and knee joint function in patients with tibial plateau fractures.Methods:From January 2017 to September 2018,74 patients with tibial plateau fractures in our hospital were prospectively studied and randomly categorized into two groups with random number table method,37 cases in each.Group A underwent minimally invasive internal fixation system(LISS)plate technology,and group B underwent anatomical plate internal fixation.The operative indexes,complication rate,perioperative pain stress(serum SP,NPY),varus angle,caster angle,knee joint range of motion and distinguished achiever ratio of knee joint function recovery at three months,six months and twelve months after the operation were compared.Results:The operation time,intraoperative blood loss,and postoperative drainage volume of group A were lower than those of group B,and the length of the incision was shorter than that of group B(P<0.05);serum SP and NPY levels in group A were lower than those in group B at the first,third,and seventh days after surgery(P<0.05);there was no significant difference between the two groups after three,six,and twelve months of varus angle,caster angle,knee joint range of motion(P>0.05);the excellent recovery rate of knee function in group A(81.08%)was not significantly different from that in group B(78.38%)(P>0.05);there was no significant difference in the incidence of complications between group A and group B(P>0.05).Conclusion:The anatomical plate internal fixation technology and LISS plate internal fixation technology have high safety and good knee joint function recovery.However,compared with the anatomical plate internal fixation technique,the LISS plate internal fixation technique has a shorter incision,which can obviously reduce the amount of intraoperative bleeding in patients with tibial plateau fractures,reduce the postoperative pain stress response,and accelerate the postoperative rehabi

关 键 词：解剖钢板内固定技术 LISS钢板内固定技术 胫骨平台骨折 应激反应 膝关节功能 P物质神经肽 

分 类 号：R68[医药卫生—骨科学]