顺行交锁钉结合LISS内固定治疗Lambiris Ⅲ或Ⅳ型股骨骨折的临床效果  

Clinical Effects of Anterograde Interlocking Nail Combined with LISS Internal Fixation in the Treatment of Lambiris Ⅲ or Ⅳ Femur Fracture

作　　者：任喜颂[1] 杜娟 时艳华 REN Xisong;DU Juan;SHI Yanhua(Department of Emergency Trauma Surgery,Nanyang Central Hospital,Nanyang 473000,China;Department of Surgery,Zhengzhou Shuqing Medical College,Zhengzhou 450000,China)

机构地区：[1]南阳市中心医院急诊创伤外科,河南南阳473000 [2]郑州澍青医学高等专科学校外科教研室,河南郑州450000

出　　处：《河南医学研究》2024年第10期1781-1785,共5页Henan Medical Research

摘　　要：目的 探究顺行交锁钉结合微创内固定系统(LISS)内固定治疗LambirisⅢ或Ⅳ型股骨骨折的应用效果。方法 前瞻性选取2022年1月至2023年1月南阳市中心医院收治的95例股骨骨折(LambirisⅢ或Ⅳ型)患者,以简单随机法分为对照组(47例)和研究组(48例)。对照组接受常规LISS内固定治疗,研究组接受顺行交锁钉结合LISS内固定治疗。比较两组围手术期情况、创伤应激因子[超氧化物歧化酶(SOD)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)]、视觉疼痛模拟量表(VAS)、硫化氢(H_(2)S)、鸢尾素(Irisin)、髋关节功能、并发症发生率。结果 研究组出血量为(357.49±32.81)mL,少于对照组的(385.94±37.26)mL,住院时间、骨折愈合时间分别为(17.63±2.29)d、(28.76±2.15)周,短于对照组的(19.51±2.64)d、(30.28±2.40)周(P<0.05)。研究组SOD、NE、AngⅡ水平术后第3天分别为(90.53±11.24)U·L^(-1)、(83.15±8.74)μg·L^(-1)、(148.62±18.53)mmol·L^(-1),低于对照组的(98.31±11.56)U·L^(-1)、(90.26±9.57)μg·L^(-1)、(163.78±19.37)mmol·L^(-1)(P<0.05)。研究组第3个月VAS评分为(1.97±0.65)分,低于对照组的(2.76±0.81)分(P<0.05);术后第3个月研究组H_(2)S、Irisin水平分别为(34.15±3.28)ng·L^(-1)、(217.83±16.45)μg·L^(-1),高于对照组的(32.28±3.11)ng·L^(-1)、(205.46±14.82)μg·L^(-1)(P<0.05);术后末次随访研究组髋关节功能优良率高于对照组(P<0.05)。结论 顺行交锁钉结合LISS内固定治疗LambirisⅢ或Ⅳ型股骨骨折患者,可减少出血,减轻应激反应,加快术后早期恢复,促进骨折愈合,恢复髋关节功能,减轻患者疼痛。Objective To investigate the clinical effect of anterograde interlocking nail combined with less invasive stabilization system(LISS)in the treatment of LambirisⅢorⅣfemur fracture.Methods A total of 95 patients with femur fracture(LambirisⅢorⅣ)in Nanyang Central Hospital from January 2022 to January 2023 were prospectively selected and divided into control group(47 cases)and study group(48 cases)by simple random method.The control group was treated with conventional LISS internal fixation,and the study group was treated with anterograde interlocking nail combined with LISS internal fixation.The operation and postoperative rehabilitation status,serum traumatic stress factors[superoxide dismutase(SOD),norepinephrine(NE),angiotensinⅡ(AngⅡ)],visual analogue scale(VAS),serum hydrogen sulfide(H 2S),Irisin,hip function and complication rate were compared between the two groups.Results The bleeding volume of the study group was(357.49±32.81)mL,which was less than(385.94±37.26)mL of the control group.The hospitalization time and fracture healing time were(17.63±2.29)d and(28.76±2.15)weeks,respectively,and they were shorter than those of the control group[(19.51±2.64)d,(30.28±2.40)weeks](P<0.05).The levels of SOD,NE and AngⅡin the study group were(90.53±11.24)U·L^(-1),(83.15±8.74)μg·L^(-1) and(148.62±18.53)mmol·L^(-1) on the third day after operation,respectively,and they were lower than those of the control group[(98.31±11.56)U·L^(-1),(90.26±9.57)μg·L^(-1),(163.78±19.37)mmol·L^(-1)](P<0.05).The VAS score of the study group in the third month was(1.97±0.65)points,which was lower than(2.76±0.81)points of the control group(P<0.05).The levels of H 2S and Irisin in the study group were(34.15±3.28)ng·L^(-1) and(217.83±16.45)μg·L^(-1),respectively,which were higher than(32.28±3.11)ng·L^(-1) and(205.46±14.82)μg·L^(-1) in the control group(P<0.05).At the last follow-up,the excellent and good rate of hip joint function in the study group was higher than that in the control group(P<0.05).

关 键 词：股骨骨折 微创内固定系统 顺行交锁钉 

分 类 号：R683[医药卫生—骨科学]