关节镜下经皮复位内固定治疗胫骨平台骨折疗效分析  

Clinical Efficacy of Arthroscopic Percutaneous Reduction and Internal Fixation in the Treatment of Tibial Plateau Fracture

作　　者：陈铎允 孙秀钦[1] CHEN Duoyun;SUN Xiuqin(Department of Orthopedics,Nanyang Central Hospital,Nanyang,Henan 473005,Chin)

机构地区：[1]南阳市中心医院骨科,河南南阳473005

出　　处：《中国烧伤创疡杂志》2024年第5期391-395,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探讨胫骨平台骨折患者采用关节镜下经皮复位内固定治疗的临床效果。方法选取2020年6月至2022年6月南阳市中心医院收治的86例胫骨平台骨折患者作为研究对象,根据不同治疗方法将其分为关节镜组(51例)和切开复位组(35例),关节镜组患者行关节镜下经皮复位内固定治疗,切开复位组患者行切开复位内固定治疗,对比观察两组患者围手术期相关指标、骨折线消失时间、应激水平、膝关节功能以及不良事件发生情况。结果关节镜组患者术中出血量明显少于切开复位组(t=29.134,P<0.001),手术时间、首次下床时间、住院时间及骨折线消失时间均明显短于切开复位组(t=9.732、14.734、9.534、5.071,P均<0.001);术后1 d,关节镜组患者神经肽Y(NPY)、前列腺素E_(2)(PGE_(2))水平均明显低于切开复位组(t=11.705、11.248,P均<0.001);术后6个月,关节镜组患者国际膝关节文献委员会膝关节评估表(IKDC)评分明显高于切开复位组(t=5.744,P<0.001),膝关节内旋、外旋、屈曲活动度均明显大于切开复位组(t=10.604、7.106、7.052,P均<0.001);关节镜组患者不良事件发生率为5.88%,明显低于切开复位组患者的不良事件发生率20.00%(χ^(2)=4.026,P=0.045)。结论胫骨平台骨折患者采用关节镜下经皮复位内固定治疗的创伤更小,术后患者应激反应更轻、不良事件发生率更低,更有利于膝关节功能恢复。Objective To study the clinical efficacy of arthroscopic percutaneous reduction and internal fixation in the treatment of patients with tibial plateau fracture.Methods 86 patients with tibial plateau fracture,admitted to Nanyang Central Hospital from June 2020 to June 2022,were enrolled as research subjects and divided into the arthroscopy group(n=51)and the open reduction group(n=35)according to the different treatment methods.Patients in the arthroscopy group were treated with arthroscopic percutaneous reduction and internal fixation,whereas patients in the open reduction group were treated with open reduction and internal fixation.Perioperative indicators,fracture line disappearance time,stress levels,knee joint function,and occurrence of adverse events were compared between the two groups.Results The intraoperative blood loss in the arthroscopy group was significantly less than that in the open reduction group(t=29.134,P<0.001).The operation time,first off-bed time,length of stay and fracture line disappearance time were all significantly shorter in the arthroscopy group compared with the open reduction group(t=9.732,14.734,9.534 and 5.071,all P<0.001).On day 1 after operation,the levels of neuropeptide Y(NPY)and prostaglandin E_(2)(PGE_(2))in the arthroscopy group were significantly lower than those in the open reduction group(t=11.705 and 11.248,both P<0.001).On month 6 after operation,the International Knee Documentation Committee knee evaluation form(IKDC)scores in the arthroscopy group were significantly higher than those in the open reduction group(t=5.744,P<0.001).The degrees of knee joint internal rotation,external rotation,and flexion range of motion were all significantly greater in the arthroscopy group(t=10.604,7.106 and 7.052,all P<0.001).The occurrence of adverse events of patients in the arthroscopy group was 5.88%,significantly lower than the corresponding 20.00%in the open reduction group(χ^(2)=4.026,P=0.045).Conclusion In the treatment of tibial plateau fracture,the therapy of arthroscopic

关 键 词：关节镜下经皮复位内固定 胫骨平台骨折 膝关节功能 应激 不良事件 

分 类 号：R687.3[医药卫生—骨科学]