高压氧联合InterTan髓内钉治疗股骨粗隆间骨折的疗效观察  

Efficacy observation of hyperbaric oxygen combined with InterTan intramedullary nail in 58 cases of intertrochanteric femur fractures

作　　者：高鹏吉[1] 吴斌[1] 杨建勋[1] Gao Pengji;Wu Bin;Yang Jianxun(No.3 Medical Area of Department of Traumatology,Linyi People’s Hospital,Linyi 276002,China)

机构地区：[1]临沂市人民医院创伤外科三病区,临沂276002

出　　处：《中华航海医学与高气压医学杂志》2023年第5期582-586,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧联合InterTan髓内钉治疗股骨粗隆间骨折患者的临床疗效及其作用机制。方法选取2020年11月至2022年11月临沂市人民医院创伤外科三病区收治的116例股骨粗隆间骨折患者作为研究对象,按照随机数字表法分为对照组和研究组,每组58例。对照组患者予以InterTan髓内钉手术治疗及对症治疗,观察组患者在对照组治疗的基础上联合高压氧治疗。根据患者治疗后髋部疼痛、功能受限、局部肿胀等临床症状进行临床疗效评估。采用全自动分析仪测定患者的血液流变学指标。采用双能X线骨密度仪测量2组患者的髋骨密度值及骨折愈合情况。采用髋关节功能Harris评分对2组患者的髋关节功能进行评估。采用全自动化学发光免疫分析仪检测2组患者的血清骨钙素(BGP)、Ⅰ型胶原氨基末端前肽(PINP)、Ⅰ型胶原羧基端肽(CTX)水平。结果观察组的临床治疗总有效率(91.38%)显著高于对照组(77.59%),差异有统计学意义(χ^(2)=4.209,P=0.040)。观察组治疗后血液黏度、红细胞沉降率、红细胞聚集指数明显低于对照组,纤维蛋白原高于对照组(P<0.05或P<0.01)。观察组治疗后1、3、6个月骨密度及骨折愈合率均明显高于对照组(P<0.05或P<0.001)。观察组治疗后1、3、6个月Harris各维度评分明显高于对照组(P<0.05)。观察组治疗后1、3、6个月血清PINP、CTX水平明显低于对照组,BGP水平明显高于对照组(P<0.05)。结论高压氧联合InterTan髓内钉治疗可有效地改善股骨粗隆间骨折患者的血液流变学指标,促进骨代谢,增加骨密度,提高骨折愈合率,具有较高的临床应用价值。Objective To investigate the clinical efficacy and mechanism of action of hyperbaric oxygen combined with InterTan intramedullary nail in patients with intertrochanteric femur fracture.Methods A total of 116 patients with intertrochanteric femur fracture admitted to No.3 Medical Area of Department of Traumatology of Linyi People’s Hospital from November 2020 to November 2022 were randomly divided into observation group and control group,with 58 cases in each group.The control group was given a new type of proximal femur intramedullary nail(InterTan)operation and symptomatic treatment,while the observation group was additionally given hyperbaric oxygen therapy.Clinical efficacy was assessed by clinical symptoms after operation,i.e.,hip pain,limited movement,and local swelling.Hemorheology indexes were detected by autoanalyzer.Hip bone density and fracture healing were assessed by Dual-energy X-ray absorptiometry.Harris hip score was used to assess hip function.Serum bone glaprotein(BGP),ProCollagen type I N-terminal propeptide(PINP),and C-terminal telopeptide of type I collagen(CTX)were measured by a fully automated chemiluminescence immunoassay analyzer.Results After treatment,the total effective rate of the observation group(91.38%)was higher than that of the control group(77.59%)(χ^(2)=4.209,P=0.040).After treatment,the blood viscosity,erythrocyte depositionrate rate,and erythrocyte aggregation indexes of the observation group were obviously lower than those of the control group,while the fibrinogen was higher than that of the control group(P<0.05 or P<0.01).After treatment,bone density and fracture healing rate in the observation group were higher than those in the control group in one month,three months,and six months after treatment,respectively(P<0.05 or P<0.001).The Harris hip scores of the observation group were higher than those of the control group in one month,three months,and six months after treatment,respectively(P<0.05).The serum PINP and CTX levels in the observation group were lower than those

关 键 词：高压氧 髓内钉 股骨粗隆间骨折 

分 类 号：R687.3[医药卫生—骨科学]