四肢创伤骨折后骨不连患者行带锁髓内钉治疗的手术效果和并发症分析手术效果和并发症分析  

Surgical Effects and Complications of Interlocking Intramedullary Nailing in Patientswith Nonunion after Traumatic Fractures of Extremities

作　　者：孙宝柱 SUN Bao-zhu(Department of nursing,Heze homemaking vocational college,Heze,Shandong 274300)

机构地区：[1]菏泽家政职业学院护理系,山东菏泽274300

出　　处：《中国伤残医学》2022年第19期5-9,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：观察对四肢创伤骨折后骨不连患者行带锁髓内钉治疗的手术效果及并发症。方法:选取我院2018年3月-2020年5月收治的四肢创伤骨折后发生骨不连患者80例,按照随机分组原则分为2组。对照组40例采用传统钢板内固定术,观察组40例采用带锁髓内钉手术,对比2组术中临床指标、血清指标、骨折愈合情况、术后功能及运动恢复情况及并发症、生活质量。结果:观察组出血量为(302.51±36.54)ml,低于对照组的(354.22±42.51)ml(P<0.05);引流量为(86.36±15.36)ml,低于对照组的(126.36±20.42)ml(P<0.05);观察组术后1个月、术后3个月Fugl-Meyer运动功能评分分别为(75.65±6.58)分、(86.32±5.21)分,均高于对照组的(70.26±7.27)分、(75.62±6.54)分(P<0.05);观察组术后并发症发生率为7.50%,低于对照组的30.00%(P<0.05);观察组术后成纤维细胞生长因子-2(FGF-2)、血清胰岛素样生长因子-1(IGF-1)明显高于对照组(P<0.05);观察组术后骨痂、骨折影像学评分、膝关节功能评分量表(HSS)评分明显高于对照组,患侧功能优良率为90.00%,高于对照组的70.00%(P<0.05);观察组术后躯体功能、心理功能、社会功能、物质生活状态评分明显高于对照组(P<0.05)。结论:对四肢创伤骨折后发生骨不连的患者行带锁髓内钉治疗,手术疗效显著,可促进术后骨折早期愈合,患者活动功能的恢复,且并发症发生率较低,从而提升生活质量。To observe the surgical effects and complications of interlocking intramedullary nailing in patients with nonunion after trauma fracture of limbs.Methods:In our hospital from March 2018 to May 2020,80 patients with nonunion after limb trauma fracture were selected and divided into two groups according to the principle of randomization.The control group was treated with traditional plate internal fixation,and the research group(40 cases)was treated with interlocking intramedullary nail.The intraoperative clinical indicators,serum indicators,fracture healing,postoperative function and motor recovery,complications and quality of life were compared between the two groups.Results:The blood loss in the study group(302.51±36.54)ml was lower than that in the control group(354.22±42.51)ml,and the drainage flow(126.36±20.42)ml was higher than that in the control group(86.36±15.36)ml(P<0.05).Fugl-meyer scores of the study group were(75.65±6.58)points and(86.32±5.21)points at 1 month and 3 months after surgery,respectively,higher than those of the control group(70.26±7.27)points and(75.62±6.54)points(P<0.05).The incidence of postoperative complications in the study group(7.50%)was lower than that in the control group(30.00%)(P<0.05).Fibroblast growth factor-2(FGF-2)and serum insulin-like growth factor-1(IGF-1)in the study group were significantly higher than those in the control group(P<0.05).The postoperative callus,fracture imaging score and knee function scale(HSS)score in the study group were significantly higher than those in the control group,and the excellent and good function rate of the affected side(90.00%)was higher than that in the control group(70.00%)(P<0.05).The scores of physical function,psychological function,social function and material life status in the study group were sig-nificantly higher than those in the control group(P<0.05).Conclusion:Interlocking intramedullary nailing has a significant therapeutic effect on patients with nonunion after traumatic fracture of limbs,which can promote early

关 键 词：四肢骨折 创伤 骨不连 带锁髓内钉 骨折愈合 功能恢复 

分 类 号：R683.4[医药卫生—骨科学]