锁骨上神经保护在锁骨骨折患者切开复位固定术中应用的效果观察  

Effectiveness Observation of Supraclavicular Nerve Protection in Application of Open Reduction and Fixation for Patients with Clavicular Fracture

作　　者：朱江[1] 符江 ZHU Jiang;FU Jiang(Department of Orthopedics and Traumatology,the Leshan Hospital of Traditional Chinese Medicine,Leshan,Sichuan 614000,China;Department of Orthopedics,the Second People's Hospital of Liangshan Yi Autonomous Prefecture,Xichang,Sichuan 615000,China)

机构地区：[1]乐山市中医医院骨伤科,四川乐山614000 [2]凉山彝族自治州第二人民医院骨科,四川西昌615000

出　　处：《解放军医药杂志》2022年第3期25-27,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省科技厅应用技术与研发项目(2018SZ0159)。

摘　　要：目的观察锁骨上神经保护在锁骨骨折患者切开复位固定术中的应用效果。方法将我院2018年8月—2020年8月收治的86例锁骨骨折患者根据内固定术中是否实施锁骨上神经保护措施分为观察组46例和对照组40例。所有患者行切开复位内固定术,观察组在术中游离保护锁骨上神经,对照组则直接切断。术后2组均随访半年,观察手术效果、手术时间、术中出血量、骨折愈合时间、术区皮肤感觉障碍面积、疼痛程度、肩关节功能及生活质量情况。结果观察组手术时间长于对照组,骨折愈合时间短于对照组(P<0.01);术后6个月,观察组手术优良率、Constant-Murly肩关节功能各维度评分、世界卫生组织生存质量测定量表简表各维度评分均明显高于对照组,观察组术区皮肤感觉障碍面积、视觉模拟评分法评分小于对照组(P<0.05,P<0.01)。结论锁骨上神经保护在锁骨骨折切开复位固定术中具有较好的应用价值,可促进患者骨折愈合,减少术后术区皮肤感觉功能障碍,缓解神经疼痛,改善肩关节功能,提高生活质量。Objective To observe effectiveness of supraclavicular nerve protection in application of open reduction and fixation for patients with clavicular fractures.Methods A total of 86 patients with clavicular fracture admitted between August 2018 and August 2020 were divided into observation group(n=46)and control group(n=40)according to whether or not having supraclavicular nerve protection during internal fixation.All patients underwent open reduction and internal fixation.The free protection of supraclavicular nerve was performed in observation group,while supraclavicular nerve was cut off directly in control group.The two groups were followed up for six months to observe the operative effectiveness,operative duration,intraoperative bleeding volume,fracture healing time,area of esthesiodermia during the operation,degree of pain,shoulder function and quality of life.Results Compared with those in control group,operative duration was significantly longer,while fracture healing time was significantly shorter in observation group(P<0.01).After operation for 6 months,in observation group,excellent and good rate of operation,dimension scores of Constant-Murly shoulder function and dimension scores of short form of the World Health Organization quality of life scale were significantly higher,while area of esthesiodermia and VAS(visual analogue scale)score in the operative area were significantly smaller or lower than those in control group(P<0.05,P<0.01).Conclusion Supraclavicular nerve protection has good value in application of open reduction and fixation for patients with clavicular fracture.It may promote fracture healing,reduce postoperative esthesiodermia in the operative area,relieve neuralgia,and improve shoulder function and quality of life.

关 键 词：骨折 锁骨 骨折固定术 内 锁骨上神经 肩关节功能 

分 类 号：R687.3[医药卫生—骨科学]