体外冲击波辅助治疗长骨干骨折术后骨不连效果的影响因素  

Factors influencing the effect of extracorporeal shock wave assisted treatment of bone nonunion after long shaft fracture

作　　者：付曙光[1] 闵智蓉[1] 周敏[2] 陈伟 林果 FU Shuguang;MIN Zhirong;ZHOU Min;CHEN Wei;LIN Guo(Department of Orthopedics,Fengcheng People's Hospital,Jiangxi Province,Yichun 336000,China;Department of Pediatrics,Fengcheng People's Hospital,Jiangxi Province,Yichun 336000,China;Department of Rehabilitation,Fengcheng People's Hospital,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省丰城市人民医院骨科,江西宜春336000 [2]江西省丰城市人民医院儿科,江西宜春336000 [3]江西省丰城市人民医院康复科,江西宜春336000

出　　处：《中国当代医药》2025年第9期44-47,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202410917)。

摘　　要：目的探讨体外冲击波辅助治疗长骨干骨折术后骨不连效果的影响因素。方法选取2022年6月至2023年12月丰城市人民医院收治的82例长骨干骨折术后骨不连患者作为研究对象,于体外冲击波术后6个月根据治疗效果将患者分为治疗有效组(53例)和治疗无效组(29例)。比较两组患者的一般资料和骨转化标志物[骨钙素(OC)、骨性碱性磷酸酶(NBAP)、β-Ⅰ型胶原羧基末端肽水平(β-CTx)],多因素logistic回归分析体外冲击波辅助治疗长骨干骨折术后骨不连效果的影响因素。结果治疗有效组的年龄低于治疗无效组,有饮酒史、有类风湿性关节炎患者占比低于治疗无效组,OC、β-CTx水平高于治疗无效组,NBAP水平低于治疗无效组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,年龄(β=1.213,OR=3.364,95%CI:1.533~7.381),NBAP水平(β=1.059,OR=2.883,95%CI:1.145~7.258)是体外冲击波辅助治疗长骨干骨折术后骨不连效果的独立危险因素,OC(β=-0.942,OR=0.390,95%CI:0.201~0.755)、β-CTx(β=-1.235,OR=0.291,95%CI:0.087~0.969)是体外冲击波辅助治疗长骨干骨折术后骨不连效果的独立保护因素(P<0.05)。结论年龄、OC、β-CTx、NBAP是体外冲击波辅助治疗长骨干骨折术后骨不连效果的独立影响因素,临床上需多加关注。Objective To investigate the factors influencing the effect of extracorporeal shock wave assisted treatment of bone nonunion after long shaft fracture.Methods A total of 82 patients with bone nonunion after long shaft fracture treated in Fengcheng People's Hospital from June 2022 to December 2023 were selected as the study subjects.According to the treatment effect,the patients were divided into effective treatment group(53 cases)and ineffective treatment group(29 cases)at 6 months after extracorporeal shock wave.The general data and bone transformation markers(osteocalcin[OC],bone al-kaline phosphatase[NBAP],typeⅠcollagen carboxy-terminal peptide[β-CTx])of the two groups were compared.Multi-variate logistic regression analysis was conducted to analyze the factors influencing the effect of extracorporeal shockwave assisted treatment of bone nonunion after long fracture.Results The age of the effective treatment group was lower than that of the ineffective treatment group,and the proportion of patients with drinking history and rheumatoid arthritis were lower than those of the ineffective treatment group,the levels of OC andβ-CTx were higher than those of the ineffective treatment group,and the level of NBAP was lower than that of the ineffective treatment group,with statistical significances(P<0.05).Multivariate logistic regression analysis showed that age(β=1.213,OR=3.364,95%CI:1.533-7.381),NBAP level(β=1.059,OR=2.883,95%CI:1.145-7.258)were in-dependent risk factors for the effect of extracorporeal shock wave assisted treatment of nonunion after long shaft fracture.OC(β=-0.942,OR=0.390,95%CI:0.201-0.755),β-CTX(β=-1.235,OR=0.291,95%CI:0.087-0.969)were independent protective factors for the effect of extracorporeal shock wave assisted treatment of nonunion after long shaft fracture(P<0.05).Conclusion Age,OC,β-CTx and NBAP are independent factors influencing the effect of extracorpo-real shockwave assisted treatment of bone nonunion after long diaphyseal fracture,which should be paid more attention to cli

关 键 词：骨转化标志物 体外冲击波 长骨干骨折 骨不连 

分 类 号：R687[医药卫生—骨科学]