经跗骨窦小切口不同内固定材料对跟骨骨折患者跟骨高度及血清IL-6、CRP水平的影响  

Effects of different internal fixation materials through small incision of tarsal sinus on the height of the calcaneus and the level of serum IL-6 and CRP in patients with calcaneal fractures

作　　者：万德余[1] 孟红亚 张伟[1] 王辞山 宋财[1] WAN De-yu;MENG Hong-ya;ZHANG Wei;WANG Ci-shan;SONG Cai(Department of Orthopedics,Bozhou People s Hospital,Bozhou 236800,Anhui,China)

机构地区：[1]亳州市人民医院创伤骨科,安徽亳州236800

出　　处：《川北医学院学报》2021年第8期1010-1014,共5页Journal of North Sichuan Medical College

基　　金：安徽省2018年高校科学研究项目(KJ2018A02229)。

摘　　要：目的:探讨经跗骨窦小切口不同内固定材料对跟骨骨折患者跟骨高度及血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平的影响。方法:选取80例跟骨骨折患者为研究对象,依据治疗方案不同分为A组和B组,每组各40例。A组予以经跗骨窦小切口空心钉内固定;B组予以经跗骨窦小切口微型锁定钢板内固定。比较两组患者手术相关指标、随访末次手术优良率,术前、术后2日及12个月随访跟骨宽度、高度、Bohler角和Gissane角,术前、术后24 h、72 h的血清IL-6、CRP水平及术后12个月随访并发症发生率。结果:A组患者手术时间短于B组(P<0.05);两组患者组手术优良率比较,差异无统计学意义(P>0.05),术后2日、术后6个月跟骨宽度、高度、Bohler角、Gissane角较术前改善(P<0.05);术后24 h, A组血清IL-6、CRP水平低于B组(P<0.05);两组术后12个月随访并发症发生率比较,差异无统计学意义(P>0.05)。结论:经跗骨窦小切口空心钉内固定和微型锁定钢板内固定手术疗效均较好,但前者能缩短手术时间,减轻手术创伤所致炎症反应。Objective:To investigate the effect of different internal fixation materials through tarsal sinus small incision on calcaneal height and serum levels of interleukin-6(Interleukin-6,IL-6)and C-reactive protein(C-reactive protein,CRP)in patients with calcaneal fracture.Methods:80 patients with calcaneal fractures were selected as the research objects.According to the treatment plan,they were divided into group A and group B,with 40 cases in each group.Group A received internal fixation with cannulated screw through small incision of tarsal sinus,and group B received internal fixation with micro locking plate through small incision of tarsal sinus.The operation related indexes,excellent and good rate of the last operation,calcaneus width,height,Bohler Angle and Gissane Angle before operation,2 days after operation and at the last follow-up,serum IL-6 and CRP levels before and 24 and 72 h after surgery,and the incidence of complications during the 12-month follow-up were compared between the two groups.Results:The operation time in group A was shorter than that in group B(P<0.05).There was no significant difference in the excellent and good rate between the two groups(P>0.05).The width,height,Bohler angle and Gissane angle of the calcaneus 2 days after the operation and 6 months after the operation in the two groups were significantly improved(P<0.05).At 24 h after operation,the serum levels of IL-6 and CRP in group A were lower than those in group B(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:The results of cannulated screw through the small incision of the tarsal sinus and the internal fixation with the mini-locking plate through the small incision of the sinus tarsal are better,but the former can shorten the operation time and reduce the stress reaction caused by surgical trauma.

关 键 词：经跗骨窦小切口 内固定材料 跟骨骨折 跟骨高度 白细胞介素6 C反应蛋白 

分 类 号：R683.42[医药卫生—骨科学]