镇痛泵持续臂丛阻滞联合早期运动康复治疗对肱骨远端C型骨折患者关节功能及血清sVCAM、IGF-1的影响  

Impacts of analgesic pump continuous brachial plexus block combined with early exercise rehabilitation on joint function and serum sVCAM and IGF-1 in patients with C-type distal humeral fractures

作　　者：于桂泳 任虹 刘娟 李美 肖爱伟 YU Gui-yong;REN Hong;LIU Juan(Department of Rehabilitation Medicine,Hengshui People's Hospital,Hengshui Hebei 053000,China)

机构地区：[1]衡水市人民医院康复医学科,河北衡水053000

出　　处：《临床和实验医学杂志》2022年第22期2455-2458,共4页Journal of Clinical and Experimental Medicine

基　　金：2017年度河北省医学科学研究重点课题计划(编号:20171216)。

摘　　要：目的分析镇痛泵持续臂丛阻滞联合早期运动康复治疗对肱骨远端C型骨折患者关节功能及血清可溶性血管细胞黏附分子(sVCAM)、胰岛素样生长因子-1(IGF-1)的影响。方法前瞻性选取2016年7月至2018年11月衡水市人民医院收治的肱骨远端C型骨折患者为研究对象,依随机分组和自愿的原则将患者分为对照组(n=32)与治疗组(n=32)。所有患者均实施肱骨远端C型骨折内固定术,其中治疗组患者术后使用镇痛泵持续臂丛阻滞镇痛,且术后早期介入运动康复治疗,对照组术后实施常规康复治疗,使用普通镇痛泵。比较患者1、3、6个月后Mayo肘关节功能评分、关节活动度;检测血清sVCAM、IGF-1水平;比较患者并发症发生情况。结果治疗组1、3、6个月后Mayo肘关节功能评分优良率为75.00%、84.38%、90.63%,显著高于对照组(50.00%、62.50%、68.75%),差异均有统计学意义(P<0.05)。治疗组患者1、3、6个月后主动关节活动度、被动关节活动度均明显高于对照组,差异均有统计学意义(P<0.05)。治疗组患者1、3、6个月后血清sVCAM水平为(540.27±54.61)、(316.79±31.88)、(300.24±30.15)ng/mL,均低于对照组[(337.52±55.42)、(390.62±39.79)、(419.26±42.13)ng/mL],1、3、6个月后血清IGF-1水平为(355.63±50.26)、(401.53±65.62)、(450.26±45.43)ng/mL,均高于对照组[(313.76±56.12)、(613.31±62.56)、(419.26±42.13)ng/mL],差异均有统计学意义(P<0.05)。治疗组患者并发症发生率为6.25%,显著低于对照组(25.00%),差异有统计学意义(P<0.05)。结论镇痛泵持续臂丛阻滞联合早期运动康复治疗,可以明显改善肱骨远端C型骨折患者关节功能,提升关节活动度,临床疗效好,值得应用推广。Objective To analyze the impacts of analgesic pump continuous brachial plexus block combined with early exercise rehabilitation on joint function and serum soluble vascular cell adhesion molecule-1(sVCAM)and insulin-like growth factor-1(IGF-1)in patients with C-type distal humeral fractures.Methods Patients with C-type distal humeral fractures admitted to Hengshui People's Hospital from July 2016 to November 2018 were prospectively selected as the research subjects.The patients were grouped into control group(n=32)and treatment group(n=32)according to the principle of randomization and voluntariness.All patients underwent internal fixation for C-type distal humeral fractures.The patients in the treatment group received continuous brachial plexus block analgesia with an analgesic pump after operation,and early interventional exercise rehabilitation after operation.The control group received routine rehabilitation after operation and a normal analgesic pump.The Mayo elbow joint function score and the range of motion of the patients were compared after 1,3 and 6 months;the levels of serum sVCAM and IGF-1 were detected;and the incidence of complications in patients was compared.Results After 1,3,and 6 months,the excellent and good rates of Mayo elbow function score in the treatment group were 75.00%,84.38%and 90.63%,which were obviously higher than those in the control group(50.00%,62.50%and 68.75%),the differences were statistically significant(P<0.05).After 1,3 and 6 months,the active joint range of motion and passive joint range of motion in the treatment group were obviously higher than those in the control group,the differences were statistically significant(P<0.05).The levels of serum sVCAM in the treatment group were(540.27±54.61),(316.79±31.88),(300.24±30.15)ng/mL,which were lower than those in the control group[(337.52±55.42),(390.62±39.79),(419.26±42.13)ng/mL]after 1,3 and 6 months,the levels of serum IGF-1 in the treatment group were(355.63±50.26),(401.53±65.62),(450.26±45.43)ng/mL,which were high

关 键 词：肱骨远端C型骨折 镇痛泵 臂丛阻滞 早期运动康复治疗 

分 类 号：R687.3[医药卫生—骨科学]