基于骨密度、骨代谢及骨小梁数量分析微创经皮锁钉钢板治疗四肢骨折的价值  

Value of minimally invasive percutaneous locking plate in treatment of limb fractures and its effect on bone mineral density,bone metabolism and trabecular bone number

作　　者：汪兆文 李杰 霍玉宝 WANG Zhao-wen;LI Jie;HUO Yu-bao(Department of Orthopedic and Traumatology,The No.4 People’s Hospital of Hengshui,Hengshui 053000,Hebei,China;Department of Hand-Foot Surgery,The No.4 People’s Hospital of Hengshui,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市第四人民医院创伤骨科,河北衡水053000 [2]衡水市第四人民医院手足外科,河北衡水053000

出　　处：《生物医学工程与临床》2023年第6期764-769,共6页Biomedical Engineering and Clinical Medicine

基　　金：衡水市科技局重点研发计划项目(2022014016Z)。

摘　　要：目的探讨基于骨密度、骨代谢及骨小梁数量分析微创经皮锁钉钢板治疗四肢骨折的优势。方法选择2020年2月至2022年12月在衡水市第四人民医院收治的200例四肢骨折患者,其中男性110例,女性90例;年龄33~49岁,平均年龄41.23岁;身体质量指数18.87~30.28 kg/m^(2),平均身体质量指数24.58 kg/m^(2);骨折时间3~6 d,平均骨折时间4.56 d;上肢骨折95例,下肢骨折105例;高血压11例,糖尿病8例,脂代谢异常3例;受伤因素,交通事故72例,机械伤53例,高处坠落75例。随机数表法将患者分为对照组100例和观察组100例,对照组患者实施钢板螺钉内固定治疗,观察组患者行微创经皮锁定加压钢板治疗。比较两组患者临床疗效、围术期指标、肢体功能、骨代谢指标、骨小梁、骨密度及并发症等参数。结果术后3个月,观察组患者优50例,良33例,一般10例,差7例,优良率为83.00%;对照组患者优20例,良30例,一般29例,差21例,优良率为50.00%;观察组优良率高于对照组,差异有统计学意义(P<0.05)。观察组患者手术时间[(65.59±9.41)min vs(95.09±9.13)min]、骨折愈合时间[(18.55±2.88)d vs(25.67±2.91)d]、住院时间[(8.19±0.99)d vs(14.53±1.54)d]和术中出血量[(119.54±10.21)mL vs(241.33±11.92)mL]明显低于对照组(P<0.05)。术后3个月,两组患者肢体功能评分明显提高,且观察组患者肢体功能评分[(20.59±1.87)分vs(15.66±1.49)分]明显高于对照组(P<0.05);两组患者血清甲状旁腺激素(PTH)和Ⅰ型胶原C端肽(CTX)明显降低,两组患者血清Ⅰ型前胶原基端前肽(PINP)明显提高,且观察组患者血清PTH[(24.43±5.01)ng/L vs(38.89±4.76)ng/L]和CTX[(463.21±50.21)ng/L vs(499.03±48.87)ng/L]明显低于对照组(P<0.05),观察组患者血清PINP[(83.32±17.01)g/L vs(72.19±9.87)g/L]明显高于对照组(P<0.05);两组患者骨密度和骨小梁数量明显提高,且观察组患者骨密度[(0.73±0.17)g/cm^(2)vs(0.62±0.15)g/cm^(2)]和骨小梁数量[(4.02±0.29)U/mL vObjective To study the minimally invasive percutaneous locking plate in treatment of limb fractures by analyzing of bone mineral density,bone metabolism and trabecular bone number.Methods From February 2020 to December 2022,a total of 200 cases of limb fractures were enrolled,which included 110 males and 90 females,aged 33-49 years old with mean age of 41.23 years old;body mass index was 18.87-30.28 kg/m^(2)with mean body mass index of 24.58 kg/m^(2);fracture time was 3-6 days with mean time of 4.56 days.There were 95 cases of upper limb fracture and 105 of lower limb fracture;11 cases of hypertension,8 of diabetes and 3 of abnormal lipid metabolism;72 cases of traffic accident,53 of mechanical injury and 75 of falling accident.All of them were divided into control group(n=100)and observation group(n=100)by random number table method.The control group was treated with plate and screw internal fixation,and observation group was treated with minimally invasive percutaneous locking plate.The clinical efficacy,perioperative indexes,limb function,bone metabolism indexes,trabecular bone,bone mineral density and complications were compared between 2 groups.Results Three-month post operation,there were 50 cases of excellent,33 cases of good,10 cases of general and 7 cases of poor in observation group,and the superior rate was 83.00%.In control group,20 cases were excellent,30 cases were good,29 cases were general and 21 cases were poor,and the superior rate was 50.00%.The superior rate of observation group was statistically significantly higher than that of control group(P<0.05).The operation time[(65.59±9.41)minutes vs(95.09±9.13)minutes],fracture healing time[(18.55±2.88)days vs(25.67±2.91)days],hospitalization time[(8.19±0.99)days vs(14.53±1.54)days]and intraoperative bleeding volume[(119.54±10.21)mL vs(241.33±11.92)mL]in observation group were significantly lower than those in control group(P<0.05).The limb function scores of 2 groups were significantly improved 3-month post operation,and limb function scores

关 键 词：微创经皮锁钉钢板 四肢骨折 骨密度 骨代谢 骨小梁 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]