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作 者:孙剑波 黄河 宋涛 郝社军 胡晓威 SUN Jianbo;HUANG He;SONG Tao;HAO Shejun;HU Xiaowei(General Medical Xi'an Hospital,Xi'an 710077;Xi'an Honghui Hospital,Xi'an 710054,China)
机构地区:[1]通用医疗西安医院,陕西西安710077 [2]西安市红会医院,陕西西安710054
出 处:《临床医学研究与实践》2023年第36期62-65,共4页Clinical Research and Practice
摘 要:目的探讨关节镜辅助下加压空心螺钉治疗SchatzkerⅡ~Ⅲ型胫骨平台骨折的效果及对下肢功能的影响。方法选取2019年1月至2022年1月收治的80例SchatzkerⅡ~Ⅲ型胫骨平台骨折患者,根据手术方式不同将其分为对照组(40例,切开复位钢板内固定)和观察组(40例,关节镜辅助下加压空心螺钉)。比较两组的治疗效果。结果观察组的手术时间长于对照组,术中出血量少于对照组,切口长度、住院时间短于对照组(P<0.05)。术后1 d,观察组的皮质醇(Cor)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)水平低于对照组(P<0.05)。术后1 d,观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-3(MMP-3)水平低于对照组(P<0.05)。术后1个月,观察组的下肢功能评分高于对照组(P<0.05)。结论相较于切开复位钢板内固定,关节镜辅助下加压空心螺钉治疗SchatzkerⅡ~Ⅲ型胫骨平台骨折手术时间更长,但术中出血量更少、创伤更小、术后恢复更快,还可减轻术后创伤应激反应及炎症反应。Objective To investigate the effect of arthroscopy-assisted compressive cannulated screw in the treatment of SchatzkerⅡ-Ⅲtibial plateau fracture and its influence on lower limb function.Methods A total of 80 patients with SchatzkerⅡ-Ⅲtibial plateau fractures admitted from January 2019 to January 2022 were selected and divided into control group(40 cases,open reduction and plate internal fixation)and observation group(40 cases,arthroscopy-assisted compressive cannulated screw)according to different surgical methods.The therapeutic effects of the two groups were compared.Results The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,and the incision length and hospitalization time were shorter than those of the control group(P<0.05).At 1 d after operation,the levels of cortisol(Cor),norepinephrine(NE)and angiotensinⅡ(AngⅡ)in the observation group were lower than those in the control group(P<0.05).At 1 d after operation,the levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and matrix metalloproteinase-3(MMP-3)in the observation group were lower than those in the control group(P<0.05).At 1 month after operation,the lower limb function score of the observation group was higher than that of the control group(P<0.05).Conclusion Compared with open reduction and plate internal fixation,arthroscopy-assisted compressive cannulated screw has a longer operation time in the treatment of SchatzkerⅡ-Ⅲtibial plateau fracture,but has less intraoperative blood loss,less trauma and faster postoperative recovery.It can also reduce postoperative traumatic stress response and inflammatory response.
关 键 词:关节镜 加压空心螺钉 SchatzkerⅡ~Ⅲ型胫骨平台骨折 下肢功能
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