髓内钉固定治疗四肢创伤开放性合并粉碎性骨折对血液流变学及Cor、IL-8水平的影响  

Effects of Intramedullary Nailing Fixation on Hemorheology and Levels of Cor and IL-8 in the Treatment of Traumatic Open and Comminted Fractures of Limbs

作　　者：陈韶宏 CHEN Shaohong(Department of orthopaedics,Wuchuan people's hospital,Guangdong province,Wuchuan,Guangdong 524500)

机构地区：[1]广东省吴川市人民医院骨科,广东吴川524500

出　　处：《中国伤残医学》2024年第5期30-34,39,共6页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨髓内钉固定治疗四肢创伤开放性合并粉碎性骨折对血液流变学及血清皮质醇(Cor)、白细胞介素-8(IL-8)水平的影响.方法:回顾性分析我院2019年6月-2021年6月收治的57例四肢创伤开放性合并粉碎性骨折患者临床资料,根据患者不同治疗方法将其分为对照组与研究组.对照组(P=27)采用钢板内固定治疗,研究组(n=30)采用髓内钉固定治疗.比较2组患者术前、术后1个月的血液流变学指标、Cor水平、IL-8水平、血清甲状旁腺激素水平、血清总Ⅰ型胶原氨基端延长肽、骨密度水平、血清骨钙素水平及术后并发症发生情况.结果:术后1个月,研究组血浆黏度、低切全血黏度、高切全血黏度均低于对照组,组间差异有统计学意义(P<0.05);研究组Cor、IL-8水平均低于对照组,组间差异有统计学意义(P<0.05);研究组血清甲状旁腺激素水平、血清总Ⅰ型胶原氨基端延长肽、骨密度水平、血清骨钙素水平均高于对照组,组间差异有统计学意义(P<0.05).研究组并发症发生率为6.66%,低于对照组的29.63%,差异有统计学意义(P<0.05).结论:采用髓内钉固定治疗四肢创伤开放性合并粉碎性骨折患者,可显著改善其血液流变学指标,并缓解炎症反应,促进骨代谢恢复正常,加快骨愈合,并发症少.Objective:To investigate the effects of intramedullary nail fixation on hemorheology and serum cortisol(Cor)and interleukin-8(IL-8)levels in the treatment of traumatic open comminted fractures of limbs.Methods:Clinical data of 57 patients with traumatic open and comminced fractures of limbs admitted to our hospital from June 2019 to June 2021 were retrospectively analyzed,and they were divided into a control group and a study group according to different treatment methods.The control group(n=27)was treated with internal plate fixation,and the study group(n=30)was treated with intramedullary nailing fixation.Hemorheology indexes,Cor level,IL-8 level,serum parathyroid hormone level,serum total type I collagen amino terminal prolongating peptide,bone mineral density level,serum osteocalcin level and postoperative complications were compared between the two groups before and 1 month after surgery.Results:1 month after surgery,the plasma viscosity,low cut whole blood viscosity and high cut whole blood viscosity of the study group were lower than those of the control group,and the differences between the two groups were statistically significant(P<0.05);the levels of Cor and IL-8 in the study group were lower than those in the control group,and the difference was statistically significant between the two groups(P<0.05);serum parathyroid hormone level,serum total type I collagen amino terminal prolongating peptide,bone mineral density level and serum osteocalcin level in the study group were higher than those in the control group,and the differences between the two groups were statistically significant(P<0.05).The incidence of complications in the study group was 6.66%,which was lower than 29.63%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The use of intramedullary nailing fixation in the treatment of patients with traumatic open and comminced fracture of limbs can significantly improve the hemorheology indexes,relieve inflammatory response,promote bone metabolism to return to

关 键 词：四肢创伤开放性并粉碎性骨折 髓内钉固定 钢板内固定 低切全血黏度 

分 类 号：R687.3[医药卫生—骨科学]