Gotfried支撑复位治疗股骨颈骨折中青年患者的临床研究  

Clinical study of Gotfried support reset in the treatment of transcervical fracture in young and middle-aged patients

作　　者：陈彦平[1] 王芳芳[1] 王金良 郜顺兴[1] 刘红正[1] 王军[1] 陶晓冰[1] 崔青[1] 眭承志[2] 吴晓阳 CHEN Yan-ping;WANG Fang-fang;WANG Jin-liang(Department of Spinal and Spinal Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,Cangzhou Hebei 061001,China)

机构地区：[1]河北省沧州中西医结合医院脊柱脊髓外科,河北沧州061001 [2]厦门大学附属第一医院康复医学科,福建厦门361003 [3]河南省骨科医院脊柱外科,河南郑州450001

出　　处：《临床和实验医学杂志》2022年第5期518-522,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省卫计委青年科技课题(编号:20171183)。

摘　　要：目的研究Gotfried支撑复位(GSR)治疗股骨颈骨折(TF)中青年患者的临床疗效。方法前瞻性纳入2017年1月至2019年12月在河北省沧州中西医结合医院脊柱脊髓外科治疗的中青年TF患者68例,依据随机数字表法将其分为GSR组(n=34)与对照组(n=34)。GSR组行GSR+内固定治疗,对照组行内固定治疗。观察两组患者手术时间、住院时间、骨折愈合时间、负重时间等手术及骨折恢复指标,术后1年髋关节评分、颈短缩分度;术前、术后1个月前列腺素E2(PGE2)、5-羟色胺(5-HT)、缓激肽(BK)、脑内神经肽Y(NPY)等致痛因子,术后1年内并发症等指标。结果GSR组手术时间为(88.96±9.27)min,大于对照组手术时间[(79.95±8.18)min],GSR组住院时间、骨折愈合时间、部分负重时间、完全负重时间为(7.69±0.83)、(115.64±12.83)、(119.79±12.77)、(157.92±16.89)d,均小于对照组住院时间[(10.94±1.16)、(141.55±15.75)、(152.73±16.93)、(189.95±20.38)d],差异均有统计学意义(P<0.05)。术后1年,GSR组髋关节功能、活动范围、疼痛、畸形及髋关节总评分为(29.97±3.38)、(3.81±0.41)、(44.31±4.63)、(4.86±0.52)、(82.95±8.94)分,均大于对照组[(23.86±2.47)、(3.34±0.35)、(38.53±3.96)、(4.22±0.45)、(69.95±7.23)分],差异均有统计学意义(P<0.05)。GSR组术后1年颈短缩分度情况优于对照组,差异有统计学意义(P<0.05)。术后1个月,GSR组PGE2、5-HT、BK、NPY水平为(121.85±13.69)pg/mL、(133.14±14.67)ng/L、(5.39±0.47)μg/L、(138.86±16.14)μg/L,低于对照组[(258.93±26.92)pg/mL、(178.69±19.38)ng/L、(8.22±0.84)μg/L、(193.78±21.33)μg/L],差异均有统计学意义(P<0.05)。术后1年内,GSR组术后并发症发生率为5.88%,低于对照组(26.47%),差异有统计学意义(P<0.05)。结论GSR治疗中青年TF可实现骨折外翻复位及阳性支撑重建,改善髋关节功能,避免颈短缩,减少术后并发症,缓解疼痛,有助于患者康复。Objective To study the clinical efficacy of got fried support reset(GSR)in the treatment of transcervical fracture(TF)in young and middle-aged patients.Methods A total of 68 young and middle-aged TF patients treated by Department of Spinal and Spinal cord Surgery,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province from January 2017 to December 2019 were divided into GSR group(n=34)and control group(n=34)according to random number table method.GSR group was treated with GSR internal fixation while control group was treated with internal fixation.The operation time,hospitalization time,fracture healing time,weight-bearing time and other operation and fracture recovery indexes,the hip joint score and neck shortening index 1 year after operation,pain factors such as prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT),bradykinin(BK)and neuropeptide Y(NPY)in the brain before and 1 month after operation,complications within 1 year after surgery,etc of the two groups were observed.Results The operative time of GSR group was(88.96±9.27)min,which was longer than that of the control group[(79.95±8.18)min],the length of hospital stay,fracture healing time,partial weight-bearing time,full weight-bearing time of GSR group were(7.69±0.83)d,(115.64±12.83)d,(119.79±12.77)d,(157.92±16.89)d,which were shorter than those of control group[(10.94±1.16)d,(141.55±15.75)d,(152.73±16.93)d,(189.95±20.38)d],and the differences were statistically significant(P<0.05).One year after operation,the hip function,range of motion,pain,deformity and total hip score in GSR group were(29.97±3.38)pionts,(3.81±0.41)pionts,(44.31±4.63)pionts,(4.86±0.52)pionts,(82.95±8.94)pionts,which were higher than those in the control group[(23.86±2.47)pionts,(3.34±0.35)pionts,(38.53±3.96)pionts,(4.22±0.45)pionts and(69.95±7.23)pionts],the differences were statistically significant(P<0.05).The degree of cervical shortening in GSR group was better than that in control group one year after operation,the difference was

关 键 词：中青年 股骨颈骨折 Gotfried支撑复位 髋关节功能 术后并发症 

分 类 号：R687.3[医药卫生—骨科学]