关节镜下复位联合微创经皮钢板固定治疗胫骨平台骨折的效果  

Efficacy of arthroscopic reduction combined with minimally invasive percutaneous plate fixation in the treatment of tibial plateau fracture

作　　者：郝世鹏 强晓军[2] 张国亮 HAO Shipeng;QIANG Xiaojun;ZHANG Guoliang(Qingfeng First Hospital;Puyang Oilfield General Hospital,Puyang 457000,Henan)

机构地区：[1]清丰第一医院 [2]濮阳市油田总医院,河南濮阳457000

出　　处：《菏泽医学专科学校学报》2022年第3期23-26,共4页Journal of Heze Medical College

摘　　要：目的探讨关节镜下复位联合微创经皮钢板固定对胫骨平台骨折患者的疗效。方法将92例胫骨平台骨折患者依据随机数字表法分为观察组和对照组,每组46例。对照组采用切开复位内固定术(ORIF),观察组采用关节镜下复位联合微创经皮钢板固定。比较两组围术期状况、治疗优良率、术前及术后1 d疼痛介质[神经肽(NPY)、前列腺素E2(PGE2)、P物质(SP)]、并发症发生率情况。结果观察组手术时长、术后引流时间、下床活动时间、完全负重时间、住院时间、骨折愈合时间短于对照组,术中失血量少于对照组(P<0.05);观察组治疗优良率高于对照组(P<0.05);术后1 d两组血清NPY、PGE2、SP水平较术前增高,但观察组低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论关节镜下复位联合微创经皮钢板内固定术治疗胫骨平台骨折,创伤小,安全性高,患者功能康复效果较好,且手术创伤所致疼痛应激反应较轻微。Objective To explore the efficacy of arthroscopic reduction combined with minimally invasive percutaneous plate fixation in the treatment of tibial plateau fracture.Methods 92 patients with tibial plateau fracture were randomly divided into the control group and the observation goup,46 cases in each group.The control group was treated with open reduction and internal fixation(ORIF),and the observation group was treated with arthroscopic reduction combined with minimally invasive percutaneous plate fixation.The perioperative status,treatment excellent rate,pain mediators levels[neuropeptide(NPY),prostaglandin E2(PGE2),substance P(SP)]before operation and 1d after operation,and complication rate were compared between the two groups.Results The operation time,postoperative drainage time,time of get out of bed,full weight-bearing time,hospitalization time,and fracture healing time in observation group were shorter than those in the control group,and intraoperative blood loss was less than that of the control group(P<0.05).The observation group's treatment excellent rate was higher than the control group(P<0.05).The serum NPY,PGE2 and SP levels of the two groups 1 d after operation were higher than those before operation,but those in the observation group was lower than those in the control group(P<0.05).The incidence of complication in the observation group was lower than that in the control group(P<0.05).Conclusion Arthroscopic reduction combined with minimally invasive percutaneous plate fixation is less traumatic,safe,with better functional rehabilitation effect,and with less pain and stress response caused by surgical trauma in the treatment of tibial plateau fracture.

关 键 词：关节镜 微创 经皮钢板固定 胫骨 骨折 

分 类 号：R683[医药卫生—骨科学]