微创内固定系统对膝关节周围骨折患者骨代谢及炎症因子等的影响  

EFFECT OF LESS INVASIVE STABILIZATION SYSTEM ON BONE METABOLISM AND INFLAMMATORY FACTORS IN PATIENTS WITH KNEE FRACTURES

作　　者：窦志刚 王功磊 庞寅田 李红霞 DOU Zhigang;WANG Gonglei;PANG Yintian;LI Hongxia(Department of Orthopedics, Luohe Hospital of Traditional Chinese Medicine, Henan 462000, China)

机构地区：[1]漯河市中医院骨科,河南漯河462000

出　　处：《精准医学杂志》2021年第5期411-413,417,共4页Journal of Precision Medicine

基　　金：2021年度河南省重点研发与推广专项支持项目(212102310199)。

摘　　要：目的探讨微创内固定系统(LISS)对膝关节周围骨折患者骨代谢及炎症因子等的影响。方法回顾性分析我院2013年1月—2018年12月收治的60例膝关节周围骨折患者的临床资料,依据治疗方法不同分为对照组及研究组,每组30例。对照组使用传统切开复位内固定术进行治疗,研究组使用LISS MIPPO技术进行治疗。比较两组患者术中指标(包括术中出血量、手术时间、切口长度)及患者恢复情况指标(包括骨愈合时间、住院时间),同时对比分析两组患者术后第15天血清中骨代谢指标[β胶联降解产物(β-CTX)、骨组织骨保护素(OPG)、血碱性磷酸酶(BALP)、Ⅰ型前胶原羧基端前肽(PICP)、血清骨钙素(BGP)]、炎症因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8]的水平及膝关节评分(HSS)。结果研究组患者术中出血量、手术时间、切口长度及骨愈合时间、住院时间均显著低于或短于对照组(t=4.62~28.56,P<0.05);两组患者术前和术后第15天血清中β-CTX、OPG、BALP、PICP、BGP、TNF-α、IL-6、IL-8水平的差值比较差异均具有显著性(t=3.42~22.79);术后第15天,研究组HSS评分及膝关节功能优良率显著高于对照组(t=2.73,χ^(2)=4.32,P<0.05)。结论相较传统切开复位内固定术,LISS MIPPO技术术中对患者的损伤更小,术后骨生成指标水平升高,骨吸收及炎症反应指标水平降低,可加快患者术后恢复,有效改善患者关节功能,具有临床推广价值。Objective To investigate the effect of less invasive stabilization system(LISS)on bone metabolism and inflammatory factors in patients with knee fractures.Methods A retrospective analysis was performed for the clinical data of 60 patients with knee fractures who were admitted to our hospital from January 2013 to December 2018,and according to the treatment method,they were divided into control group and study group,with 30 patients in each group.The patients in the control group were treated with traditional open reduction and internal fixation,and those in the study group were treated with LISS minimally invasive percutaneous plate osteosynthesis(MIPPO).The two groups were compared in terms of intraoperative indicators(intraoperative blood loss,time of operation,and incision length)and recovery indicators(bone healing time and length of hospital stay),as well as the levels of bone metabolic markers[βisomer of C-terminal telopeptide of typeⅠcollagen(β-CTX),osteoprotegerin(OPG)in bone tissue,bone alkaline phosphatase(BALP)in blood,procollagenⅠC-terminal propeptide(PICP),and serum bone Gla protein(BGP)],levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8)],and Hospital for Special Surgery(HSS)knee joint score on day 15 after surgery.Results Compared with the control group,the study group had significantly lower intraoperative blood loss and significantly shorter time of operation,incision length,bone healing time,and length of hospital stay(t=4.62-28.56,P<0.05).There were significant differences between the two groups in the changes in the serum levels ofβ-CTX,OPG,BALP,PICP,BGP,TNF-α,IL-6,and IL-8 on day 15 after surgery(t=3.42-22.79),and compared with the control group,the study group had significantly higher HSS score and excellent and good rate of knee joint function on day 15 after surgery(t=2.73,χ^(2)=4.32,P<0.05).Conclusion Compared with traditional open reduction and internal fixation,the LISS MIPPO technique causes less damage to the patient du

关 键 词：骨折固定术 内 最小侵入性外科手术 MIPPO技术 骨折 膝关节 骨代谢 细胞因子类 

分 类 号：R683[医药卫生—骨科学] R687.3[医药卫生—外科学]