不同时机应用跨关节外固定支架治疗SchatzkerⅥ型胫骨平台骨折的临床效果比较  

Comparison of clinical effects of useing cross-articular external fixator at different times in the treatment of Schatzker typeⅥtibial plateau fractures

作　　者：王晶 王虹 WANG Jing;WANG Hong(Emeryency Department Fire Emergency Support Department of Xi'an Xianyang International Airport,Xi'an 712035;Rehabilitation Medicine Department,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710082,China)

机构地区：[1]西安咸阳国际机场消防急救保障部急救科,陕西西安712035 [2]空军军医大学第一附属医院康复医学科,陕西西安710082

出　　处：《临床医学研究与实践》2024年第22期100-103,共4页Clinical Research and Practice

摘　　要：目的比较不同时机应用跨关节外固定支架治疗SchatzkerⅥ型胫骨平台骨折的临床效果。方法选取2020年1月至2022年5月收治的78例SchatzkerⅥ型胫骨平台骨折患者,根据应用跨关节外固定支架治疗的时机不同将其分为对照组和观察组,各39例。对照组在骨折后24~72 h应用跨关节外固定支架治疗,观察组在骨折后12 h内应用跨关节外固定支架治疗。比较两组的手术效果。结果观察组的治疗优良率高于对照组(P<0.05)。观察组的Ⅰ期术后水疱发生率、Ⅰ期术后肿胀程度低于对照组,入院至Ⅱ期手术时间、住院时间及骨折愈合时间短于对照组(P<0.05)。术后,观察组的P物质(SP)、前列腺素E_(2)(PGE_(2))、缓激肽(BK)水平低于对照组(P<0.05)。术后,观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)及基质金属蛋白酶-3(MMP-3)水平低于对照组(P<0.05)。结论早期应用跨关节外固定支架有助于减轻SchatzkerⅥ型胫骨平台骨折患者周围软组织损伤,提高治疗效果,也能减轻疼痛和炎症反应,值得临床推广。Objective To compare the clinical effects of useing cross-articular external fixator at different times in the treatment of Schatzker typeⅥtibial plateau fractures.Methods A total of 78 patients with Schatzker typeⅥtibial plateau fractures admitted from January 2020 to May 2022 were selected and divided into control group and observation group according to different timing of treatment with cross-articular external fixator,with 39 cases in each group.The control group was treated with cross-articular external fixator at 24-72 h after fracture,and the observation group was treated with cross-articular external fixator within 12 h after fracture.The surgical effects of the two groups were compared.Results The excellent and good rate of treatment of the observation group was higher than that of the control group(P<0.05).The incidence of blisters after stageⅠoperation and the degree of swelling after stageⅠoperation in the observation group were lower than those in the control group,and the time from admission to stageⅠoperation,hospitalization time and fracture healing time were shorter than those in the control group(P<0.05).After operation,the levels of substance P(SP),prostaglandin E_(2)(PGE_(2))and bradykinin(BK)in the observation group were lower than those in the control group(P<0.05).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).Conclusion Early application of cross-articular external fixator can help to reduce the soft tissue injury around patients with Schatzker typeⅥtibial plateau fracture,improve the therapeutic effect,and also reduce pain and inflammatory response,which is worthy of clinical promotion.

关 键 词：不同时机 跨关节外固定支架 SchatzkerⅥ型胫骨平台骨折 周围软组织损伤 

分 类 号：R687.3[医药卫生—骨科学]