机器人辅助拉力螺钉内固定手术对骨盆骨折患者Majeed评分步态参数的影响  

Effect of Robot-Assisted Tension Screw Internal Fixation Surgery on Majeed Score and Gait Parameters in Patients with Pelvic Fractures

作　　者：罗鸿 LUO Hong(Beijing Jishuitan Hospital Guizhou Hospital,Guizhou Guiyang 550001,China)

机构地区：[1]北京积水潭医院贵州医院骨科一病区,贵州贵阳550001

出　　处：《河北医学》2023年第9期1512-1520,共9页Hebei Medicine

基　　金：贵州省科技计划项目,(编号:黔科合支撑[2018]2763)。

摘　　要：目的:探讨机器人辅助拉力螺钉内固定手术对骨盆骨折(PF)患者Majeed评分、步态参数的影响。方法:总结2022年2月至2023年2月我院86例PF患者,依据治疗方案分为两组,各43例。对照组行人工切开复位固定术,观察组行机器人辅助拉力螺钉内固定手术。比较两组手术相关指标(手术时间、术中出血量、首次下地负重时间、住院时间)、Majeed评分、Matta评分、疼痛情况、采用酶联免疫法检测手术前后血清应激反应指标去甲肾上腺素(NE)、肿瘤坏死因子-α(TNF-α)、血管紧张素Ⅱ(AngⅡ)、C反应蛋白(CRP),全自动化学发光免疫分析仪检测血清骨折愈合相关指标碱性磷酸酶(ALP)、骨钙素(BGP)、骨保护素(OPG),术后步态参数(步速、步幅及支撑时间百分比)及不良反应情况。结果:观察组手术时间、术中出血量、首次下地负重时间及住院时间均少于对照组(P<0.05);观察组术后3个月Majeed评分、Matta评分优良率均高于对照组(P<0.05);观察组术后疼痛程度低于对照组(P<0.05);观察组术后24h、72h血清NE、TNF-α、AngⅡ及CRP水平低于对照组,术后1、3个月血清ALP、BGP及OPG水平高于对照组(P<0.05);术后3、6个月观察组步速、步幅及支撑时间百分比高于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论:机器人辅助拉力螺钉内固定手术治疗PF,能优化手术,减轻应激反应,缓解患者疼痛,同时促进骨折愈合,改善患者骨盆功能,恢复机体协调性,提高手术安全性。Objective:To investigate the effect of robot-assisted tension screw internal fixation surgery on Majeed score and gait parameters in patients with pelvic fracture(PF).Methods:Eighty-six patients with PF in our hospital from Februarry 2022 to Februarry 2023 were selected and divided into two groups based on the treatment plan,43 patients each.The control group underwent manual incisional repositioning and fixation,and the observation group underwent robot-assisted tension screw internal fixation.The surgical indicators(surgical time,intraoperative bleeding,time to first weight-bearing,length of hospital stay)of the two groups were compared,as well as Majeed score,Matta score,and pain status.Enzyme-linked immunosorbent assay(ELISA)was used to detect the serum stress response indicators Norepinephrine(NE),tumor necrosis factor-α(TNF-α),angiotensinⅡ(AngⅡ),C-reactive protein(CRP)before and after surgery.Fully automated chemiluminescence immunoassay analyzer was used to analyze serum fracture healing-related indexes alkaline phosphatase(ALP),osteocalcin(BGP),osteoprotegerin(OPG),postoperative gait parameters(stride speed,stride length,and percentage of support time),and adverse effects.Results:The operating time,intraoperative bleeding,time to first weight-bearing on the ground and hospital stay were less in the observation group than in the control group(P<0.05);the excellent rates of Majeed score and Matta score were higher in the observation group than in the control group at 3 months after surgery(P<0.05);the degree of postoperative pain was lower in the observation group than in the control group(P<0.05).The serum NE,TNF-α,Ang II and CRP levels in the observation group were lower than those in the control group at 24 h and 72 h after surgery,and the serum ALP,BGP and OPG levels were higher than those in the control group at 1 and 3 months after surgery(P<0.05);the gait speed,stride length and percentage of support time in the observation group were higher than those in the control group at 3 and 6 months af

关 键 词：骨盆骨折 拉力螺钉内固定 机器人 应激反应 骨盆功能 骨折愈合指标 步态参数 

分 类 号：R687.3[医药卫生—骨科学]