带锁髓内钉内固定术与动力加压钢板内固定术治疗四肢创伤开放性并粉碎性骨折患者的效果比较  

Comparison of effects of interlocking intramedullary nail internal fixation and dynamic compression plate internal fixation in treatment of patients with open and comminuted traumatic fractures of extremities

作　　者：陈威 樊峰 陈阳 袁柳松 CHEN Wei;FAN Feng;CHEN Yang;YUAN Liusong(Department of Orthopaedics of Xinyang People’s Hospital,Xinyang 464000 Henan,China)

机构地区：[1]信阳市人民医院骨科,河南信阳464000

出　　处：《中国民康医学》2023年第7期146-149,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较带锁髓内钉内固定术与动力加压钢板内固定术治疗四肢创伤开放性并粉碎性骨折患者的效果。方法:选取2019年3月至2022年3月该院收治的100例四肢创伤开放性并粉碎性骨折患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。对照组采用动力加压钢板内固定术治疗,观察组采用带锁髓内钉内固定术治疗。比较两组手术相关指标(术中出血量、手术时间、术后引流量和住院时间)水平、治疗优良率、术后肢体运动功能[Fugl-Meyer评定量表(FMA)]评分和手术前后血液流变学指标[红细胞沉降率(ESR)、血浆黏度]水平及并发症发生率。结果:观察组术中出血量、术后引流量均少于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05);观察组治疗优良率为94.00%(47/50),高于对照组的74.00%(37/50),差异有统计学意义(P<0.05);术后随访6个月,观察组上、下肢FMA评分均高于对照组,差异有统计学意义(P<0.05);术后,观察组血浆黏度、ESR水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为12.00%(6/50),低于对照组的36.00%(18/50),差异有统计学意义(P<0.05)。结论:带锁髓内钉内固定术治疗四肢创伤开放性并粉碎性骨折患者可减少术中出血量、术后引流量,缩短住院时间,提高治疗优良率和肢体运动功能评分,以及降低血液流变学指标水平和并发症发生率,效果优于动力加压钢板内固定术治疗。Objective:To compare effects of interlocking intramedullary nail internal fixation and dynamic compression plate internal fixation in treatment of patients with open and comminuted traumatic fractures of extremities.Methods:A prospective study was conducted on 100 patients with open and comminuted traumatic fractures of extremities admitted to this hospital from March 2019 to March 2022.They were divided into control group and observation group according to the random number table method,50 cases in each.The control group was treated with dynamic compression plate internal fixation,while the observation group was treated with interlocking intramedullary nail internal fixation.The operation related index levels(intraoperative blood loss,operation time,postoperative drainage volume and hospitalization time),the excellent and good rate of treatment,the incidence of complications,the postoperative limb motor function[Fugl-Meyer assessment(FMA)]score,and the hemorheology index levels[erythrocyte sedimentation rate(ESR),plasma viscosity]were compared between the two groups before and after the operation.Results:The intraoperative blood loss and the postoperative drainage volume of the observation group were less than those of the control group,the hospitalization time was shorter than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in hospitalization time between the two groups(P>0.05).The excellent and good rate of treatment in the observation group was 94.00%(47/50),which was higher than 74.00%(37/50)in the control group,and the difference was statistically significant(P<0.05).After 6 months of follow-up,the FMA scores of the upper and lower limbs in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the operation,the levels of plasma viscosity and ESR in the observation group were lower than those in the control group,and the differences were statistically significa

关 键 词：粉碎性骨折 四肢创伤 开放性骨折 动力加压钢板内固定术 带锁髓内钉内固定术 运动功能 血液流变学 

分 类 号：R683.4[医药卫生—骨科学]