不同植入物内固定治疗四肢创伤骨折后骨不连患者的临床疗效及对并发症的影响  

Clinical effeicacy of different implants in the treatment of patients with bone nonunion after traumatic fracture of extremities and its influence on complications

作　　者：姚霖[1] 林晨荣 余斌 谭辉[1] 徐保 YAO Lin;LIN Chenrong;YU Bin;TAN Hui;XU Bao(Department of Limb Trauma,Lushan Rehabilitation and Rehabilitation Center of Joint Logistic Support Force of People's Liberation Army of China/171 Hospital of the People's Liberation Army,Jiujiang,Jiangxi,332000,China)

机构地区：[1]中国人民解放军联勤保障部队庐山康复疗养中心/解放军171医院四肢创伤科,江西九江332000

出　　处：《当代医学》2024年第24期28-32,共5页Contemporary Medicine

摘　　要：目的探讨不同植入物内固定治疗四肢创伤骨折后骨不连患者的临床疗效及对并发症的影响。方法选取2019年1月至2023年1月中国人民解放军联勤保障部队庐山康复疗养中心收治的102例四肢创伤骨折骨不连患者作为研究对象,随机分为对照组与观察组,每组51例。对照组实施加压钢板内固定治疗,观察组实施交锁髓内钉固定治疗,比较两组治疗优良率、围手术期相关指标、氧化应激[促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、皮质醇(cortisol,Cor)]水平、术后运动功能[Fugl-Meyer功能运动(Fugl-Meyer assessment,FMA)]、生命质量[健康调查量表36(36-item short form health survey,SF-36)]及并发症发生情况。结果观察组治疗优良率为96.08%,高于对照组的84.31%,差异有统计学意义(P<0.05)。两组手术时间比较差异无统计学意义;观察组术中出血量、术后引流量均少于对照组,骨折愈合时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组术后并发症总发生率为3.92%,低于对照组的17.65%,差异有统计学意义(P<0.05)。术后,两组血清ACTH水平均高于术前,Cor水平均低于术前,且观察组血清ACTH、Cor水平均低于对照组,差异有统计学意义(P<0.05)。术后,两组FMA评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。术后,两组生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康评分高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论采用交锁髓内钉固定技术四肢创伤骨折后骨不连患者能改善围手术期指标,促进骨折早期恢复,减少相关并发症,提高治疗优良率及患者生命质量。Objective To investigate the clinical efficacy of different implants in the treatment of patients with bone nonunion after traumatic fracture of extremities and its influence on complications.Methods A total of 102 patients with bone nonunion after traumatic fracture of extremities admitted to Lushan Rehabilitation and Recuperation Center of Joint Logistic Support Force of People's Liberation Army of China from January 2019 to January 2023 were selected as the study subjects,and they randomly divided into the control group and the observation group,with 51 cases in each group.The control group was treated with pressure plate and the observation group was treated with interlocking intramedullary nailing,the excellent and good rate of treatment,perioperative related indicators,oxidative stress(adrenocorticotropic hormone[ACTH],cortisol[Cor])levels,postoperative motor function(Fugl-Meyer assessment[FMA]),quality of life(36-item short form health survey[SF-36])and complications were compared between the two groups.Results The excellent and good rate of treatment in the observation group was 96.08%,which was higher than 84.31%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in operation time between the two groups;the intraoperative blood loss and postoperative drainage volume in the observation group were less than those in the control group,and the fracture healing time and hospital stay were shorter than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 3.92%,which was lower than 17.65%in the control group,and the difference was statistically significant(P<0.05).After operation,the serum ACTH and Cor levels of the two groups were higher than before operation,and the serum ACTH and Cor levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After o

关 键 词：内固定 四肢创伤骨折 骨不连 临床疗效 并发症 

分 类 号：R68[医药卫生—骨科学]