低频脉冲电磁场对骨质疏松性胸腰椎骨折内固定术后康复的促进作用  

Promoting effect of low-frequency pulsed electromagnetic field on postoperative rehabilitation of osteoporotic thoracolumbar fractures treated with internal fixation

作　　者：冉仁国 罗政 廖鑫 张付民 Ran Renguo;Luo Zheng;Liao Xin;Zhang Fumin(Department of Spinal Surgery,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院脊柱外科,445000

出　　处：《中华老年骨科与康复电子杂志》2024年第1期39-45,共7页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：湖北省科技厅自然科学基金项目(2019CFB615)。

摘　　要：目的探讨低频脉冲电磁场对骨质疏松性胸腰椎骨折内固定术后康复的促进作用。方法将118例骨质疏松性胸腰椎骨折内固定术后患者采用随机数字表分两组。对照组给予唑来膦酸治疗,观察组给予低频脉冲电磁场联合唑来膦酸治疗。对比两组患者疼痛程度,骨折愈合时间,治疗前后的骨密度,骨代谢指标水平与腰椎功能评分变化。结果111例患者均获得完整随访,随访率94.07%,随访时间6~12个月,平均(9.00±1.08)个月。其中观察组男20例、女37例,年龄50~83岁,平均(64.50±5.65)岁;对照组男18例、女36例,年龄50~83岁,平均(64.05±5.82)岁。观察组和对照组不同时刻疼痛评分进行重复测量设计的方差分析显示,观察组和对照组组间差异有统计学意义[观察组:(8.51±0.79)分、(5.72±0.65)分、(2.86±0.41)分,对照组:(8.96±0.91)分、(6.38±0.72)分、(4.77±0.53)分](F=12.451,P<0.001),组别与时间点间存在交互作用(F=11.338,P<0.001),各时间点两组差异均有统计学意义(F=2.786、5.074、21.301,P=0.006、<0.001、<0.001);观察组在各时间点间差异均有统计学意义(F=18.967,P<0.001);观察组骨折愈合时间短于对照组[(12.31±2.07)周比(14.76±2.25)周](t=6.125,P<0.001);观察组和对照组治疗前与治疗6个月后在腰椎(L1~L4)骨密度、N-MID、β-CTx和PINP水平及腰椎功能障碍评分[观察组:(0.65±0.07)g/cm2与(0.71±0.08)g/cm2、(15.58±3.01)ng/mL与(8.82±1.23)ng/mL、(0.32±0.06)ng/mL与(0.13±0.02)ng/mL、(32.89±4.33)ng/mL与(54.56±7.37)ng/mL、(60.18±5.20)分与(15.88±3.01)分;对照组:(0.64±0.06)g/cm2与(0.67±0.07)g/cm2、(15.43±2.96)ng/mL与(11.24±1.74)ng/mL、(0.31±0.06)ng/mL与(0.19±0.04)ng/mL、(33.02±4.41)ng/mL与(41.23±6.06)ng/mL、(59.25±5.43)分与(24.35±4.20)分],进行重复测量设计的方差分析显示,观察组和对照组组间差异有统计学意义(F=12.401、15.468、18.742、16.229、18.924,均P<0.001),组别与时间点间存在交互作用(F=8.065、12.2Objective To promoting effect of low-frequency pulsed electromagnetic field on postop-erative rehabilitation of osteoporotic thoracolumbar fractures treated with internal fixation.Methods 118 patients with osteoporotic thoracolumbar fractures undergoing internal fixation were divided into 2 groups by a random digital table.The control group was given zoledronic acid,while the observation group was given low-frequency pulsed electromagnetic field combined with zoledronic acid.The pain degree,fracture healing time,the levels of bone density,indicators of bone metabolism and lumbar function before and after treat-ment were compared between the two groups.Results 111 patients received complete follow-up,with a fol-low-up rate of 94.07%.The follow-up time was 6-12 months,with an average of(9.00±1.08)months.The analysis of variance of repeated measurement design for pain scores at different time points between the ob-servation group and the control group showed statistically significant differences between the observation group and the control group[observation group:(8.51±0.79)scores,(5.72±0.65)scores,(2.86±0.41)scores,control group:(8.96±0.91)scores,(6.38±0.72)scores,(4.77±0.53)scores](F=12.451,P<0.001).There was an interaction between the groups and time points(F=11.338,P<0.001),and the differences between the two groups at each moment were statistically significant(F=2.786,5.074,21.301,P=0.006,<0.001,<0.001).The differences in the observation group between each two moments were statistically significant(F=18.967,P<0.001).The fracture healing time in the observation group was shorter than that in the control group[(12.31±2.07)weeks vs(14.76±2.25)weeks](t=6.125,P<0.001).The analysis of variance of repeated measurement design for the bone density,N-MID,β-CTx and PINP levels and lumbar dysfunction scores showed statisti-cally significant differences between the observation group and the control group[observation group:(0.65±0.07)g/cm2 and(0.71±0.08)g/cm2,(15.58±3.01)ng/mL and(8.82±1.23)ng/mL,(0.32±0.06)n

关 键 词：低频脉冲电磁场 骨质疏松症 胸腰椎骨折 内固定术 骨密度 

分 类 号：R683[医药卫生—骨科学]