生骨片结合泰勒空间支架截骨延长术治疗开放性胫骨骨折并骨缺损的临床研究  

Clinical Study on Shenggu Tablets Combined with Extension Osteotomy Using Taylor Spatial Frame in the Treatment of Open Tibial Fracture with Bone Defect

作　　者：余卓安 高峻青[2] 王朝辉[2] 詹晓欢 YU Zhuo-An;GAO Jun-Qing;WANG Zhao-Hui;ZHAN Xiao-Huan(The Eighth Clinical Medical School of Guangzhou University of Chinese Medicine,Foshan 528000 Guangdong,China;Dept.of Reparative and Reconstructive Surgery,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000 Guangdong,China)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]佛山市中医院修复重建外科,广东佛山528000

出　　处：《广州中医药大学学报》2024年第12期3173-3179,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省重点领域研发计划项目(编号:2020B1111150001);广东省基础与应用基础研究基金项目(编号:2022A1515220061);佛山市重点领域科技攻关项目(编号:2020001006106)。

摘　　要：【目的】探讨生骨片(由煅自然铜、苏木、降香、三七、知母、地黄、地龙、龙骨等组成)结合泰勒空间支架截骨延长术治疗开放性胫骨骨折并骨缺损的临床疗效。【方法】回顾性分析2018年7月~2022年9月佛山市中医院收治的73例开放性胫骨骨折并骨缺损(骨缺损超过4 cm)患者的临床资料,根据有无使用生骨片将患者分为观察组37例和对照组36例。对照组接受泰勒空间支架截骨延长术治疗,观察组接受生骨片结合泰勒空间支架截骨延长术治疗,直至骨愈合。比较2组患者术后6个月的临床治疗效果、影像学总有效率、骨折愈合时间以及并发症的发生情况。【结果】(1)临床治疗效果和影像学总有效率方面,术后6个月,观察组的临床优良率和影像学总有效率分别为100.00%(37/37)、100.00%(37/37),明显高于对照组的83.33%%(30/36)、86.11%(31/36),组间比较,差异均有统计学意义(P<0.05)。(2)骨折愈合时间方面,观察组的骨折愈合时间为(11.47±0.77)个月,较对照组的(14.42±1.40)个月明显缩短,差异有统计学意义(P<0.01)。(3)术后并发症方面,观察组患者的术后并发症总发生率为13.51%(5/37),明显低于对照组的38.89%(14/36),差异有统计学意义(P<0.05)。【结论】生骨片结合泰勒空间支架截骨延长术治疗开放性胫骨骨折并骨缺损,能显著促进骨折愈合,提高骨搬运和成骨矿化速度,缩短骨折愈合时间,减少戴架时间,疗效肯定。Objective To explore the clinical efficacy of Shenggu Tablets(mainly composed of Pyritum,Sappan Lignum,Dalbergiae Odoriferae Lignum,Notoginseng Radix et Rhizoma,Anemarrhenae Rhizoma,Rehmanniae Radix,Pheretima,and Os Draconis)combined with extension osteotomy using Taylor spatial frame(TSF)in the treatment of open tibial fracture with bone defect.Methods The clinical data of 73 patients with open tibia fracture and bone defect more than four centimeters admitted to Foshan Hospital of Traditional Chinese Medicine from July 2018 to September 2022 were retrospectively analyzed.The patients were divided into the observation group(37 cases)and the control group(36 cases)according to the medication of Shenggu Tablets or not.The control group was treated with extension osteotomy using TSF,and the observation group was treated with Shenggu Tablets combined with extension osteotomy using TSF until the healing of fractures.Six months after the operation,the clinical effect,total effective rate assessed by imaging,fracture healing time,and the incidence of complications in the two groups were compared.Results(1)Six months after the operation,the distinguished rate of clinical efficacy and the total effective rate assessed by imaging in the observation group were all 100.00%(37/37),which were significantly higher than those in the control group[83.33%(30/36),86.11%(31/36)respectively],and the intergroup comparison showed that the differences were statistically significant(P<0.05).(2)The fracture healing time of the observation group was(11.47±0.77)months,which was significantly shorter than that of the control group[(14.42±1.40)months],and the difference was statistically significant(P<0.01).(3)The total incidence of postoperative complications in the patients of the observation group was 13.51%(5/37),which was significantly lower than that in the control group[38.89%(14/36)],with a statistically significant difference(P<0.05).Conclusion Shenggu Tablets combined with extension osteotomy using TSF exerts certain efficacy in

关 键 词：开放性胫骨骨折 泰勒空间支架 截骨延长术 生骨片 骨缺损 骨搬运 

分 类 号：R274.12[医药卫生—中医骨伤科学]