闭合复位交锁髓内钉内固定术对胫骨中下段骨折患者创伤应激指标及关节功能的影响  

Effect of Closed Reduction and Interlocking Intramedullary Nail Internal Fixation on Trauma Stress Indicators and Joint Function in Patients with Middle and Lower Tibial Fractures

作　　者：孙魁 马强 SUN Kui;MA Qiang(Department of Orthopedics,Zhoucun District People's Hospital of Zibo City,Zibo 255300,China)

机构地区：[1]山东省淄博市周村区人民医院骨外科,山东淄博255300

出　　处：《中国伤残医学》2024年第18期62-65,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探究闭合复位交锁髓内钉(IMN)内固定术对胫骨中下段骨折患者创伤应激指标及关节功能的影响。方法:回顾性分析2021年1月-2023年12月淄博市周村区人民医院收治的100例胫骨中下段骨折患者资料,根据手术方式不同分为对照组(n=48)及研究组(n=52)。对照组行切开复位有限接触加压钢板(LC-DCP)内固定术,研究组行IMN内固定术。比较两组患者的创伤应激指标、炎性因子水平、关节功能及并发症发生情况。结果:术后3 d,研究组皮质醇、去甲肾上腺素、血管紧张素-Ⅱ、肿瘤坏死因子-α、白细胞介素-6水平均低于对照组,差异均有统计学意义(P<0.05)。研究组Johner-Wruhs评分优良率为94.23%,高于对照组的79.17%,差异有统计学意义(P<0.05)。研究组并发症发生率为3.85%,低于对照组的18.75%,差异有统计学意义(P<0.05)。结论:相较于LC-DCP,IMN内固定术治疗胫骨中下段骨折患者可减轻其创伤应激程度,减少机体炎症反应,减少并发症发生情况,利于改善关节功能。结论:相较于LC-DCP,IMN内固定术治疗胫骨中下段骨折患者可减轻创伤应激、炎症反应,减少并发症,改善关节功能。Objective:To investigate the effects of closed reduction and interlocking intramedullary nail(IMN)internal fixation on trauma stress indicators and joint function in patients with middle and lower tibial fractures.Methods:Data of 100 patients with middle and lower tibial fractures admitted to Zhoucun District People's Hospital of Zibo City from January 2021 to December 2023 were retrospectively selected as the study objects and were divided into a control group(n=48)and a study group(n=52)according to different surgical methods.The control group underwent open reduction limited contact dynamic compression plate(LC-DCP)internal fixation,and the study group underwent IMN internal fixation.The traumatic stress indicators,inflammatory factors,joint function and complications were compared between the two groups.Results:At 3 days after operation,the levels of cortisol,norepinephrine,angiotensin-ⅱ,tumor necrosis factor-αand interleukin-6 in the study group were lower than those in the control group,with statistical significance(P<0.05).The Johner-Wruhs score in the study group was 94.23%,higher than79.17%in the control group,the difference was statistically significant(P<0.05).The complication rate of the study group was 3.85%,which was lower than 18.75%of the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with LC-DCP,IMN internal fixation in the treatment of patients with middle and lower tibial fractures can reduce the degree of traumatic stress,reduce the inflammatory response of the body,reduce the incidence of complications,and improve joint function.

关 键 词：胫骨中下段骨折 闭合复位交锁髓内钉内固定术 创伤应激指标 炎性因子水平 关节功能 并发症 

分 类 号：R684[医药卫生—骨科学]