Ilizarov外固定架用于糖尿病Charcot神经关节病患者对其关节功能及血清PGE2、NGF的影响  

Effects of Ilizarov external fixator on joint function and serum PGE2 and NGF in patients with diabetic Charcot neuroarthropathy

作　　者：许英[1] 贺银习 周红艳[1] 张彩霞[1] 刘魁[1] XU Ying;HE Yin-xi;ZHOU Hong-yan(Department of Trauma and Orthopedics,Shijiazhuang City Third Hospital,Shijiazhuang Hebei 050011,China)

机构地区：[1]石家庄市第三医院创伤骨科,河北石家庄050011

出　　处：《临床和实验医学杂志》2023年第16期1750-1754,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省2021年度医学科学研究课题计划项目(编号:20211298)。

摘　　要：目的探讨Ilizarov外固定架用于糖尿病Charcot神经关节病患者对其关节功能及血清前列腺素E2(PGE2)、神经生长因子(NGF)的影响。方法采用回顾性分析方法,研究对象为2020年1月至2022年1月石家庄市第三医院收治的行踝关节融合术的100例糖尿病Charcot神经关节病患者,按照不同手术方案分为髓内钉组(逆行髓内钉治疗,n=40)和外固定架组(Ilizarov外固定架治疗,n=60)。比较两组患者关节骨融合率、愈合时间、术后临床疗效和术后不良反应发生率,对比两组患者术前及术后4周血清PGE2、NGF水平,并统计两组患者术前和术后末次随访时美国足踝外科学协会(AOFAS)评分、术后末次随访时生活质量调查表(SF-36)评分。结果外固定架组关节骨融合率高于髓内钉组,愈合时间短于髓内钉组,差异均有统计学意义(P<0.05)。外固定架组术后临床疗效优于髓内钉组,差异有统计学意义(P<0.05)。术后4周,两组血清PGE2、NGF水平均较术前降低,且外固定架组低于髓内钉组,差异均有统计学意义(P<0.05)。外固定架组术后不良反应发生率低于髓内钉组,差异有统计学意义(P<0.05)。两组术后AOFAS评分均较术前升高,且外固定架组高于髓内钉组,差异均有统计学意义(P<0.05)。外固定架组末次随访时生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能和精神健康评分均高于髓内钉组,差异均有统计学意义(P<0.05)。结论Ilizarov外固定架是治疗糖尿病Charcot神经关节病患者的有效选择,可调节血清疼痛-炎症介质表达,增加关节骨融合率,缩短愈合时间,降低不良反应发生率,改善生活质量。Objective To investigate the effects of Ilizarov external fixation on joint function,serum prostaglandin E2(PGE2)and nerve growth factor(NGF)in patients with diabetic Charcot neurojoint disease.Methods Retrospective analysis was used.The study subjects were 100 patients with diabetic Charcot neuroarthropathy who underwent ankle arthrofusion in Shijiazhuang City Third Hospital from January 2020 to January 2022.They were divided into intramedullary nailing group(retrograde intramedullary nailing treatment,n=40)and external fixator group(Ilizarov external fixator treatment,n=60).The joint and bone fusion rate,healing time,postoperative clinical outcome and postoperative adverse incidence were compared between the two groups.Serum PGE2 and NGF levels were compared between the two groups before surgery and 4 weeks after surgery,and American Association for Foot and Ankle Surgery(AOFAS)score before surgery and last follow-up after surgery and SF-36 score at last follow-up after surgery were collected.Results The fusion rate of external fixator group was higher than that of intramedullary nailing group,and the healing time was shorter than that of intramedullary nailing group,the differences were statistically significant(P<0.05).The postoperative clinical efficacy of the external fixator group was better than that of the intramedullary nail group,the difference was statistically significant(P<0.05).At 4 weeks after surgery,the serum levels of PGE2 and NGF in the two groups decreased compared to before surgery,and the external fixator group were lower than those of intramedullary nail group,the differences were statistically significant(P<0.05).The incidence of postoperative adverse events in the external fixator group was lower than that in the intramedullary nail group,the difference was statistically significant(P<0.05).The postoperative AOFAS scores of the two groups increased compared to before surgery,and that in the external fixator group was higher than that in the intramedullary nail group,the differences were

关 键 词：ILIZAROV外固定架 逆行髓内钉 糖尿病Charcot神经关节病 踝关节融合术 

分 类 号：R587.2[医药卫生—内分泌] R747.9[医药卫生—内科学]