Ilizarov骨短缩-延长及皮瓣修复术对胫腓骨骨折伴软组织缺损患者功能康复及氧化应激的影响  

Effect of Ilizarov bone shortening lengthening and skin flap repair on functional rehabilitation and oxidative stress in patients with tibia fibula fracture and soft tissue defect

作　　者：孙庆禄 高鸣[1] 田连国 胡志勇 SUN Qinglu;GAO Ming;TIAN Lianguo;HU Zhiyong(Department of Orthopedics,East Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000,China;Department of Orthopedics,Third People's Hospital of Botou City,Cangzhou Hebei 062150,China)

机构地区：[1]河北省沧州中西医结合医院东院区骨科,河北沧州061000 [2]泊头市第三人民医院骨科,河北沧州062150

出　　处：《新疆医科大学学报》2023年第5期653-658,共6页Journal of Xinjiang Medical University

基　　金：河北省卫生健康委员会计划项目(20210573)。

摘　　要：目的 探讨Ilizarov骨短缩-延长及皮瓣修复术对胫腓骨骨折伴软组织缺损患者功能康复及氧化应激的影响。方法 选取2020年7月至2022年7月河北省沧州中西医结合医院收治的98例胫腓骨骨折伴软组织缺损患者,随机分为对照组与研究组,每组各49例。对照组采取皮瓣修复+Ilizarov骨搬运术,研究组采取Ilizarov骨短缩-延长+皮瓣修复术。统计并分析两组患者围术期情况、治疗优良率、手术前后踝关节功能及膝关节、应激反应指标水平、并发症发生率等。结果 (1)研究组围术期情况优于对照组(P<0.05);(2)研究组治疗优良率(89.80%)高于对照组(85.71%),但差异无统计学意义(P>0.05);(3)两组术后踝-后足评分系统(AOFAS)、膝关节美国特种外科医院(HSS)表评分较术前增高,且研究组较对照组高(P<0.05);(4)两组术后去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)、醛固酮(ALD)水平较术前增高,但研究组低于对照组(P<0.05);(5)研究组并发症发生率(4.08%)低于对照组(10.20%),但差异无统计学意义(P>0.05)。结论 Ilizarov骨短缩-延长及皮瓣修复术可促进胫腓骨骨折伴软组织缺损创面及骨折愈合,恢复机体功能,且可减轻手术创伤所致应激反应程度。Objective To investigate the effects of Ilizarov bone shortening lengthening and skin flap repair on functional rehabilitation and oxidative stress in patients with tibiofibular fracture and soft tissue defect.Methods 98 patients with tibia and fibula fracture accompanied by soft tissue defect admitted to East Hospital of Integrated Traditional Chinese and Western Medicine from July 2020 to July 2022 were randomly divided into control group and study group,with 49 cases in each group.The control group was treated with skin flap repair+Ilizarov bone transfer,while the study group was treated with Ilizarov bone shortening lengthening+skin flap repair.Perioperative situation,excellent and good rate of the treatment,ankle joint function and knee joint before and after the surgery,stress response index level,incidence of complications and so on were analyzed.Results(1)The perioperative condition of the study group was better than that of the control group(P<0.05).(2)The rate of good treatment in study group(89.80%)was higher than that in control group(85.71%),but there was no statistical significance(P>0.05).(3)Postoperative scores of ankle-hind foot scoring system(AOFAS)and the American Hospital for Special Surgery(HSS)table of knee joint were higher in two groups than before thesurgery,and study group was higher than control group(P<0.05).(4)The levels of norepinephrine(NE),epinephrine(E),cortisol(Cor)and aldosterone(ALD)in the two groups were higher after the surgery,but study group was lower thancontrol group(P<0.05).(5)The incidence of complications in study group(4.08%)was lower than that in control group(10.20%),but the difference was not statistically significant(P>0.05).Conclusion Ilizarov bone shortening lengthening and skin flap repair can promote wound healing of tibia fibula fracture with soft tissue defect,restore body function,reduce stress reaction caused by surgical trauma.

关 键 词：Ilizarov骨短缩-延长 皮瓣修复术 胫腓骨骨折 软组织缺损 功能康复 氧化应激 

分 类 号：R605[医药卫生—外科学]