微创经皮钢板接骨术联合锁定加压钢板内固定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 internal fixation in treatment of patients with distal tibial fractures

作　　者：和亚南 段长合 董德涛 HE Yanan;DUAN Changhe;DONG Detao(Department of Orthopedics,Xinxiang County People’s Hospital,Xinxiang 453700 Henan,China)

机构地区：[1]新乡县人民医院骨科,河南新乡453700

出　　处：《中国民康医学》2024年第19期48-50,54,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内固定术治疗胫骨远端骨折患者的效果。方法:选取2020年1月至2023年6月该院收治的60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研究组和对照组各30例。研究组采用微创经皮钢板接骨术联合锁定加压钢板内固定术治疗,对照组采用切开复位钢板内固定术治疗。比较两组手术优良率,围术期指标(住院时间、骨折愈合时间、术中出血量)水平,手术前后踝关节功能[美国足踝外科协会踝-后足评分量表(AOFAS-AH)]评分、疼痛[视觉模拟评分法(VAS)]评分、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93.33%(28/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05);研究组住院时间、骨折愈合时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);术后1个月,研究组AOFAS-AH评分高于对照组,术后7 d,研究组VAS评分低于对照组,差异均有统计学意义(P<0.05);术后3 d,研究组E、β-EP、Cor水平均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:微创经皮钢板接骨术联合锁定加压钢板内固定术治疗胫骨远端骨折患者可提高手术优良率和踝关节功能评分,改善围术期指标水平,降低疼痛评分和应激指标水平,效果优于切开复位钢板内固定术治疗。Objective:To observe effects of minimally invasive percutaneous plate osteosynthesis combined with locking compression plate internal fixation in treatment of patients with distal tibial fractures.Methods:A prospective study was conducted on 60 patients with distal tibial fractures admitted to this hospital from January 2020 to June 2023.According to the random number table method,they were divided into study group and control group,30 cases in each group.The study group was treated with minimally invasive percutaneous plate osteosynthesis combined with locking compression plate internal fixation,while the control group was treated with open reduction plate internal fixation.The excellent and good rate of surgery,the perioperative indexes(hospitalization time,fracture healing time,intraoperative blood loss)levels,the ankle function[American orthopaedic foot and ankle society-hindfoot scale(AOFAS-AH)],the pain[visual analogue scale(VAS)]score,and the stress indexes[epinephrine(E),β-endorphin(β-EP),cortisol(Cor)]before and after the surgery,and the incidence of complications were compared between the two groups.Results:The excellent and good rate of surgery in the study group was 93.33%(28/30),which was higher than 73.33%(22/30)in the control group,and the difference was statistically significant(P<0.05).The hospitalization time and the fracture healing 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 AOFAS-AH score of the study group was higher than that of the control group;7 days after the surgery,the VAS score of the study group was lower than that of the control group;and the differences were statistically significant(P<0.05).3 days after the surgery,the levels of E,β-EP and Cor in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant d

关 键 词：微创经皮钢板接骨术 锁定加压钢板内固定术 胫骨远端骨折 疼痛 踝关节功能 应激 

分 类 号：R683.42[医药卫生—骨科学]