对合端植骨内固定术联合Ilizarov骨搬移术对下肢大段骨缺损患者愈合情况、骨再生相关因子及并发症发生率的影响  

The effect of joint bone grafting and internal fixation combined with Ilizarov bone transfer on the healing,bone regeneration-related factors and complication rate in patients with large-segment bone defects of the lower extremities

作　　者：艾晓明 申博统 李磊 Ai Xiaoming;Shen Botong;Li Lei(Beihai Hospital,Xuchang City,Xuchang,Henan 461000)

机构地区：[1]许昌市北海医院,河南许昌461000

出　　处：《辽宁医学杂志》2023年第4期72-76,共5页Medical Journal of Liaoning

摘　　要：目的研究下肢大段骨缺损患者应用对合端植骨内固定术联合Ilizarov骨搬移术对骨再生相关因子、安全性及患者愈合情况的影响。方法选取我院2018年4月至2020年3月期间82例下肢大段骨缺损患者作为研究对象,采取随机数字表法进行分组,对照组41例行Ilizarov骨搬移术,观察组41例加用对合端植骨内固定术,两组均采用酶联免疫法测定骨再生相关因子,对比两组愈合情况、对合端接触后即刻与接触后10d骨再生相关因子水平,血清细胞转化生长因子β(TGF-β)、碱性成纤维细胞生长因子(bFGF)、血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)的表达水平及并发症发生率。结果观察组骨愈合时间、骨愈合指数、外固定时间低于对照组,骨愈合优良率高于对照组,有统计学意义(P<0.05);对合端接触后即刻,观察组与对照组骨再生相关因子水平差异无统计学意义(P>0.05);接触后10d,观察组骨再生相关因子(bFGF、PDGF、VEGF、TGF-β)高于对照组,有统计学意义(P<0.05);观察组骨钉道感染、力线不良、对合端不愈合等并发症发生率低于对照组,有统计学意义(P<0.05)。结论对合端植骨内固定术联合Ilizarov骨搬移术对下肢大段骨缺损效果确切,能够提高骨再生相关因子水平,值得临床推广使用。Objective To investigate the effects of internal fixation of conjoint bone grafting combined with Ilizarov bone removal on bone regeneration related factors,safety and healing of patients with large bone defects of lower extremities.Methods From April 2018 to March 2020,82 patients with large bone defects of lower extremities in our hospital were se-lected as the research objects.They were divided into two groups by random number table method.41 patients in the control group received Ilizarov bone transfer surgery,and 4l patients in the observation group received internal fixation with optical-ly combined end bone graft.The healing status of the two groups,the levels of bone regeneration related factors immediately after contact and 10 days after contact,the expression levels of TCF-β,basic fibroblast growth factor(bFGF),platelet-de-rived growth factor(PDCF)and vascular endothelial growth factor(VECF)in serum and the incidence of complications were compared.Results The bone healing time,bone healing index and external fixation time in the observation group were low-er than those in the control group,and the excellent and good rate of bone healing was higher than that in the control group,with statistical significance(P<0.05).Immediately after contact of the contralateral ends,there was no significant differ-ence in bone regeneration related factors between the observation group and the control group(P>0.05).On day 10 after exposure,bone regeneration related factors(bFCF,PDGF,VEGF and TCF-β)in the observation group were higher than those in the control group,with statistical significance(P<0.05).The incidence of complications in the observation group was lower than that in the control group,with statistical significance(P<0.05).Conclusion The combined internal fixa-tion with Ilizarov is effective in treating large bone defects of lower limbs and can improve the level of bone regeneration fac-tors,which is worthy of clinical application.

关 键 词：对合端植骨内固定术 下肢大段骨缺损 骨再生相关因子 

分 类 号：R687.3[医药卫生—骨科学]