股骨骨折合并脑外伤内固定方法的对比研究  

作　　者：徐小明[1] 钱雨欣 

机构地区：[1]浙江省常山县人民医院,324200 [2]浙江省龙泉市人民医院,323700

出　　处：《浙江临床医学》2021年第4期531-533,共3页Zhejiang Clinical Medical Journal

摘　　要：目的对比研究带锁髓内钉及微创钢板用于股骨骨折合并脑外伤内固定的临床价值.方法回顾性分析2018年10月到2020年10月本院收治的73例股骨骨折合并脑外伤患者的临床资料,按照手术方式的不同分为微创钢板组(38例)和带锁髓内钉组(35例).比较两组围手术期的一般指标和术后1周、3个月患者的Harris髋关节功能(HHS)评分与骨生长相关血清因子水平,以及术后并发症的发生情况.结果微创钢板组患者的手术时间和手术出血量均显著低于带锁髓内钉组.术后3个月两组患者的疼痛、功能、畸形及活动度评分显著高于术后1周(P<0.05);微创钢板组术后1周的疼痛评分显著高于带锁髓内钉组(P<0.05).术后3个月两组患者的血清VEGF、IGF-1、BMP-2水平显著高于术后1周(P<0.05);微创钢板组术后3个月的VEGF水平显著高于带锁髓内钉组(P<0.05).结论微创钢板内固定对减少手术时间、手术出血量及术后疼痛有积极意义,临床应用可优先考虑.Objective To compare and study the clinical value of interlocking intramedullary nail and minimally invasive steel plate for internal fixation of femoral fractures combined with traumatic brain injury.Methods The clinical data of 73 patients with femoral fractures and brain trauma admitted to our hospital were retrospective analyzed from October 2018 to October 2020.According to the different surgical methods,they were divided into a minimally invasive steel plate group(38 cases)and a locking intramedullary nail group(35 cases).The general indicators of the perioperative period and the Harris hip function(HHS)scores and the levels of hone growth-reLited serum factors of the patients at 1 week«md 3 months after the operation were compared between the two groups,as well as the occurrence of postoper.itive complications.Results The operation time and blood loss ot the minimally invasive steel plate group were significantly lower than those of the locking intramedullary nail group.The pain,flmction,deformity and mobility scores of the two groups of patients at 3 months after surgery were significantly higher than those of the 1 week after surgery(P<0.05);the pain scores of the minimally invasive steel plate group at 1 week after surgery were significantly higher than that of the interlocking intramedullary nail Group(P<0.05).Semm VEGF,IGF-1,and BMP-2 levels of the two groups of patients were significantly higher than 1 week after operation(P<0.05);the VEGF levels of the minimally invasive steel plate group were significantly higher than those of the lock-in group at 3 months after operation.Intramedullary nail group(P<0.05).Conclusion Minimally invasive steel plate internal fixation has a positive significance in reducing operation time,surgical bleeding and postoperative pain,and clinical application can be given priority.

关 键 词：股骨骨折合并脑外伤 内固定方式 带锁髓内钉 微创钢板 

分 类 号：R68[医药卫生—骨科学]