早期微创内固定手术联合鼠神经生长因子治疗创伤性多发性肋骨骨折的效果及对骨形态发生蛋白水平的影响  

Efficacy of early minimally invasive internal fixation combined with mouse nerve growth factor for treatment of traumatic multiple rib fractures and its influence on bone morphogenetic protein level

作　　者：宋志明 焦昌结 陈检明 郭军华 钟京[1] 蔡伟斌 余小平 陈松林[1] 易云峰[1] SONG Zhi-ming;JIAO Chang-jie;CHEN Jian-ming;GUO Jun-hua;ZHONG Jing;CAI Wei-bin;YU Xiao-ping;CHEN Song-lin;YI Yun-feng(Department of Cardiothoracic Surgery,the No.909 Hospital of the Chinese PLA Joint Logistics Support Force(Southeast Hospital Affiliated to Xiamen University),Zhangzhou 363000,China)

机构地区：[1]中国人民解放军联勤保障部队第九○九医院(厦门大学附属东南医院)心胸外科,福建省漳州市363000

出　　处：《广西医学》2020年第20期2670-2673,共4页Guangxi Medical Journal

基　　金：军队后勤科研项目(CWH17J030CNJ14C007)。

摘　　要：目的探讨早期微创内固定手术联合鼠神经生长因子治疗创伤性多发性肋骨骨折患者的效果,以及对血清骨形态发生蛋白(BMP)-2、BMP-7水平的影响。方法选取120例创伤性多发性肋骨骨折患者,随机分为研究组和对照组各60例。研究组患者给予早期微创内固定手术联合鼠神经生长因子治疗,对照组患者仅给予早期微创内固定手术进行治疗。比较两组患者的临床疗效、骨痂出现时间、骨痂体积、治疗4周后骨痂最大直径、总住院时间、胸管留置时间、术后2个月疼痛视觉模拟量表(VAS)评分以及治疗前后血清BMP-2、BMP-7水平。结果研究组治疗有效率高于对照组,骨痂出现时间早于对照组,骨痂体积和治疗4周后骨痂最大直径均大于对照组(均P<0.05)。与对照组比较,研究组住院时间、胸管留置时间更短,VAS评分更低(均P<0.05)。两组患者治疗后的血清BMP-2、BMP-7水平均高于术前,且研究组血清BMP-2、BMP-7水平均高于对照组(均P<0.05)。结论与单纯微创内固定术比较,早期微创内固定手术联合术后鼠神经生长因子注射能更有效地治疗创伤性多发性肋骨骨折,提高患者血清BMP-2、BMP-7水平,促进骨折愈合。Objective To investigate the efficacy of early minimally invasive internal fixation combined with mouse nerve growth factor for the treatment of patients with traumatic multiple rib fractures,as well as its influence on the levels of serum bone morphogenetic protein(BMP)-2 and BMP-7.Methods A total of 120 patients with traumatic multiple rib fractures were selected and randomly divided into study group(n=60)and control group(n=60).Patients in the study group were given early minimally invasive internal fixation combined with mouse nerve growth factor therapy,while patients in the control group were given early minimally invasive internal fixation surgery for treatment.Clinical efficacy,callus appearance time,callus volume,maximum diameter of the callus after four weeks of treatment,total hospitalization time,chest tube indwelling time,the Visual Analogue Scale(VAS)score two months postoperatively,as well as serum BMP-2 and BMP-7 levels before and after treatment were compared between the two groups.Results The study group had a higher effective rate for treatment,earlier occurrence of callus,greater callus volume,and increased maximum diameter of the callus after four weeks of treatment than the control group(all P<0.05).Compared with the control group,the study group exhibited shorter hospitalization time,shorter chest tube indwelling time,and lower VAS score(all P<0.05).After treatment,serum BMP-2 and BMP-7 levels were higher than preoperative levels in both groups,and the study group reported higher serum BMP-2 and BMP-7 levels than the control group(all P<0.05).Conclusion Compared to simple minimally invasive internal fixation,early minimally invasive internal fixation combined with postoperative injection of mouse nerve growth factor can treat traumatic multiple rib fractures more effectively,improve patients′serum BMP-2 and BMP-7 levels,and promote fracture healing.

关 键 词：创伤性多发性肋骨骨折 早期微创内固定手术 鼠神经生长因子 骨形态发生蛋白2 骨形态发生蛋白7 疗效 

分 类 号：R683.1[医药卫生—骨科学]