经皮微创锁定钢板内固定术辅助关节腔内玻璃酸钠注射对胫骨平台粉碎性骨折术后综合应激状态的影响  

Effect of intravarticular articular injection of sodium hyaluronate combined with percutaneous minimally invasive locked plate fixation on the comprehensive stress status after comminuted fracture of the tibial platform

作　　者：张成绩 王海虎 倪进荣 张群虎 邓杰林 ZHANG Chengji;WANG Haihu;NI Jinrong;ZHANG Qunhu;DENG Jielin(Department of Orthopedic,Suqian First People’s Hospital,Jiangsu,Suqian 223800,China)

机构地区：[1]江苏省宿迁市第一人民医院骨科,223800

出　　处：《临床外科杂志》2024年第4期368-371,共4页Journal of Clinical Surgery

基　　金：2020年江苏省宿迁市卫生健康委员会科技计划项目(K202001)。

摘　　要：目的 探讨经皮微创锁定钢板内固定术辅助关节腔内注射玻璃酸钠对胫骨平台粉碎性骨折术后综合应激状态的影响。方法 前瞻性选择2020年6月~2021年6月我院收治的胫骨平台粉碎性骨折病人84例,按随机数字表法将其分为单纯手术组(A组)和手术辅助玻璃酸钠注射组(B组),每组各42例。A组行经皮微创锁定钢板内固定术,B组在A组的基础上辅助关节腔内玻璃酸钠注射治疗。比较两组临床疗效。结果 随访3个月后,B组拆线后负重时间、愈合时间均显著短于A组(P<0.05);B组术后第1、4周膝关节活动度及Rasmussen评分高于A组,两组比较差异有统计学意义(P<0.05);B组术后第3、7天视觉模拟评分(VAS)低于A组,两组比较差异有统计学意义(P<0.05);B组术后第3、7天白细胞介素(IL)-6、外周血血沉(ESR)、血清C反应蛋白水平(CRP)低于A组,两组比较差异有统计学意义(P<0.05);B组术后第3、7天过氧化氢酶(CAT)、总抗氧化能力(SOD)、超氧化物歧化酶水平(TAC)均高于A组,两组比较差异有统计学意义(P<0.05)。结论 经皮微创锁定钢板内固定术辅助关节腔内注射玻璃酸钠治疗胫骨平台骨折疗效良好。Objective Explore the effect of percutaneous minimally invasive locking plate internal fixation combined with intra-articular injection of sodium hyaluronate on the postoperative comprehensive stress state of tibial plateau comminuted fractures.Methods A prospective study was conducted on 84 patients with tibial plateau comminuted fractures from June 2020 to June 2021.They were randomly divided into a minimally invasive group and a combination group,with 42 patients in each group.The minimally invasive group underwent percutaneous minimally invasive locking plate internal fixation(group A),while the combined group received intra-articular injection of sodium hyaluronate on the basis of the minimally invasive group(group B).Compare the efficacy of two groups of indicators.Results After 3 months of follow-up,the weight bearing time and healing time in the group B were significantly shorter than those in the group A(P<0.05).The knee joint motion and Rasmussen score of group B at the 1st and 4th week after surgery were higher than those of group A,and the difference between the two groups was statistically significant(P<0.05).The visual analogue scale(VAS)of the group B on the 3rd and 7th day after surgery was significantly lower than that of the group A(P<0.05).On the 3rd and 7th day after surgery,the levels of interleukin-6(IL-6),peripheral blood sedimentation rate(ESR),and serum C-reactive protein(CRP)in the group B were lower than those in the group A(P<0.05).On the 3rd and 7th day after surgery,the levels of catalase(CAT),total antioxidant capacity(SOD),and superoxide dismutase(TAC)in the group B were higher than those in the group A(P<0.05).Conclusion The combination of percutaneous minimally invasive locking plate internal fixation and intra-articular injection of sodium hyaluronate for the treatment of tibial plateau fractures has a good therapeutic effect.

关 键 词：胫骨平台粉碎性骨折 内固定 钢板 玻璃酸钠 应激状态 

分 类 号：R687.3[医药卫生—骨科学]