微创经皮钢板接骨术联合锁定加压钢板术治疗胫骨远端骨折患者的效果  

Effects of minimally invasive percutaneous plate osteosynthesis combined with locking compression plate fixation in treatment of patients with distal tibial fractures

作　　者：张东阳 ZHANG Dongyang(Second Department of Orthopaedics of Nanyang Second General Hospital,Nanyang 473300 Henan,China)

机构地区：[1]南阳市第二人民医院骨科二病区,河南南阳473300

出　　处：《中国民康医学》2024年第13期61-64,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察微创经皮钢板接骨术联合锁定加压钢板术治疗胫骨远端骨折患者的效果。方法:选取2021年1月至2023年1月该院收治的68例胫骨远端骨折患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各34例。对照组采用切开复位内固定术治疗,研究组采用微创经皮钢板接骨术联合锁定加压钢板术治疗,比较两组手术优良率,围术期指标(骨折愈合时间、住院时间、术中出血量)水平,手术前后膝关节功能[Lyshom膝部量表(LKS)评分、屈膝度]、疼痛[视觉模拟评分法(VAS)]评分、氧化应激指标[肾上腺素(E)、β-内啡肽(β-EP)、皮质醇(Cor)]水平,以及并发症发生率。结果:研究组手术优良率为88.24%(30/34),高于对照组的67.65%(23/34),差异有统计学意义(P<0.05);研究组骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后1个月,两组LKS评分、屈膝度均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后7 d,两组VAS评分均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后7 d,两组E、β-EP、Cor水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为8.82%(3/34),低于对照组的29.41%(10/34),差异有统计学意义(P<0.05)。结论:微创经皮钢板接骨术联合锁定加压钢板术治疗胫骨远端骨折患者,可提高手术优良率,改善预后及膝关节功能,减轻疼痛程度和机体氧化应激反应,降低并发症发生率,效果优于切开复位内固定术治疗。Objective:To observe effects of minimally invasive percutaneous plate osteosynthesis combined with locking compression plate fixation in treatment of patients with distal tibial fractures.Methods:A prospective study was conducted on 68 patients with distal tibial fractures admitted to this hospital from January 2021 to January 2023.According to the random number table method,they were divided into control group and study group,34 cases in each group.The control group was treated with open reduction and internal fixation,while the study group was treated with minimally invasive percutaneous plate osteosynthesis combined with locking compression plate fixation.The surgery excellent and good rate,the perioperative indexes(fracture healing time,hospitalization time,intraoperative blood loss),the knee joint function [Lyshom knee scale(LKS),knee flexion degree],the pain [visual analogue scale(VAS)] score,the oxidative stress index [epinephrine(E),β-endorphin(β-EP),cortisol(Cor)] levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The surgery excellent and good rate in the study group was 88.24%(30/34),which was higher than 67.65%(23/34) in the control group,and the difference was statistically significant(P<0.05).The fracture healing time and the hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).1 month after the surgery,the LKS score and the knee flexion of the two groups were higher than those before the surgery,those of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).7 days after the surgery,the VAS scores of the two groups were lower than those before the surgery,that in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05).7 days after the surgery,the levels

关 键 词：微创经皮钢板接骨术 锁定加压钢板术 胫骨远端骨折 骨折愈合 关节功能 氧化应激 并发症 

分 类 号：R683.42[医药卫生—骨科学]