可塑性腕关节支具联合石氏伤科三色敷药治疗桡骨远端骨折的临床研究  

Clinical Study on Shi′s Sanse Plaster Combined with Plastic Wrist Brace Treating Distal Radius Fracture

作　　者：桂璟 吴海洋 吴军豪 闻国伟 沈祉培 余益群 张吉仁 GUI Jing;WU Haiyang;WU Junhao;WEN Guowei;SHEN Zhipei;YU Yiqun;ZHANG Jiren(Orthopedics Department,Huangpu Branch of Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院黄浦分院骨伤科,上海200011

出　　处：《中国医药导刊》2020年第12期838-843,共6页Chinese Journal of Medicinal Guide

基　　金：上海市黄浦区科委项目(项目编号:HKW201608,项目名称:石氏自制支具在桡骨远端骨折临床运用的研究)。

摘　　要：目的:观察可塑性腕关节支具联合石氏伤科三色敷药治疗桡骨远端骨折的临床疗效及安全性。方法:采用随机数字表法,将符合纳入标准的180例桡骨远端骨折AO分型A、B型的患者随机分为3组:支具+三色敷药组、支具组及石膏组,各组病例分别60例。纳入的骨折患者,经常规的手法复位后,分别采用不同的固定方式。分别于治疗前及治疗后第2、4、6、8周随访并记录患者患腕VAS疼痛评分、Cooney腕关节功能评分及不良事件发生情况,并做统计学比较。结果:支具+三色敷药组在VAS疼痛评分改善程度上优于支具组(t=3.151,P=0.0021)以及石膏组(t=3.393,P=0.0009),而支具组和石膏组比较差异无统计学意义(t=0.4984,P=0.6191);随访第8周Cooney腕关节功能评分,支具+三色敷药优于支具组(t=2.184,P=0.0309)以及石膏组(t=2.67,P=0.0087),而支具组和石膏组比较差异无统计学意义(t=0.6371,P=0.5253);支具+三色敷药组A型骨折患者的Cooney功能评分优于B型骨折患者(t=4.216,P<0.0001);支具组和石膏组A型骨折与B型骨折患者的Cooney功能评分差异无统计学意义(t=1.222,P=0.2266;t=0.597,P=0.5528);三组张力性水泡发生率的差异有统计学意义(χ2=10.29,P=0.0058),而皮肤过敏和骨折再移位发生率的差异无统计学意义(χ2=0.7746,P=0.6789;χ2=2.019,P=0.364)。结论:可塑性腕关节支具联合石氏伤科三色敷药治疗能够减轻腕关节疼痛,促进功能恢复,安全性较高,值得临床推广应用;适应症包括桡骨远端骨折A型、部分B型骨折中后期固定等。临床应用注意膏药过敏等禁忌。Objective:To evaluate the clinical effect and safety of plastic wrist brace combined with Shi′s Sanse plaster in treating distal radius fracture.Methods:According to the random coding table,patients with type A and B distal radius fracture were randomly divided into 3 groups:plastic wrist brace combined with Shi′s Sanse plaster group,plastic wrist brace group and gypsum plaster group,with 60 cases in each group(180 cases in total).After manipulation,plastic wrist brace combined with Shi′s Sanse plaster,plastic wrist brace,gypsum plaster support were applied respectively in the three groups for fixation.The VAS pain scores,Cooney wrist function scores and adverse events of the three groups were recorded and compared before the treatment and 2,4,6 and 8 weeks after the treatment.Results:The VAS score in the brace with Shi′s Sanse group was superior to the brace group(t=3.151,P=0.0021)and the gypsum group(t=3.393,P=0.0009),and there was no statistical difference between the latter two groups(t=0.4984,P=0.6191).8 weeks after the treatment,the Cooney wrist function score of the brace with Shi′s Sanse group was superior to that of the brace group(t=2.184,P=0.0309)and the gypsum group(t=2.67,P=0.0087),and there was no statistical difference between the latter two groups(t=0.6371,P=0.5253).The Cooney functional score of patients with type A fracture was better than that of patients with type B fracture in the plastic wrist brace combined with Shi′s Sanse plaster group(t=4.216,P<0.0001),and there was no statistical difference in Cooney functional scores between type A fracture patients and type B fracture patients in the brace group and the plaster group(t=1.222,P=0.2266;t=0.597,P=0.5528).There was statistical difference in the incidence of tension blisters among the three groups(χ2=10.29,P=0.0058),and no statistical difference in the incidence of skin allergy and fracture redisplacement(χ2=0.7746,P=0.6789;χ2=2.019,P=0.364).Conclusion:For patients with distal radial fractures of type A and some type B patie

关 键 词：桡骨远端骨折 可塑性支具 三色敷药 保守治疗 

分 类 号：R68[医药卫生—骨科学]