摘要
目的比较外固定架固定和切开复位内固定治疗创伤性四肢骨折的临床疗效,观察两种术式对机体炎症应激反应的影响。方法选取2016年5月至2018年11月解放军陆军第947医院收治的200例创伤性四肢骨折患者,随机分为对照组和观察组,每组各100例,前者采用传统切开复位内固定治疗,后者采用外固定架治疗,比较两组患者的临床疗效和并发症发生情况,以及手术前后炎症应激反应指标的变化。结果观察组患者术中出血量、住院时间、住院费用及骨折愈合时间均小于对照组(P<0.05);术后两组血清白细胞介素-1、促肾上腺皮质激素、肾上腺素、去甲肾上腺素水平均较术前明显升高,但观察组明显低于对照组(P<0.05);末次随访时两组优良率及并发症发生率比较,差异无统计学意义(P>0.05)。结论外固定架固定与切开复位内固定两种术式治疗创伤性四肢骨折均能取得良好的短期疗效,但前者术中出血更少,术后机体炎症应激反应程度更轻微,利于患者的骨折愈合和功能恢复,降低了手术费用。
Objective To compare the clinical effects of external fixation versus open reduction and internal fixation(ORIF)in the treatment of traumatic limb fractures,and to observe the effects of two procedures on body inflammatory reaction and stress response.Methods A total of 200 patients with traumatic fractures of the extremities treated from May 2016 to November 2018 in 947 Hospital of PLA Army,were randomly divided into control group and observation group with 100 patients in each group.Patients in control group underwent conventional ORIF,while patients in observation group were performed external fixation.Clinical efficacy and postoperative complications,as well as changes of indexes of inflammatory and stress responses before and after the surgery in two groups were compared.Results Intraoperative estimate blood loss,hospital stay,hospitalization expenses and bone healing time of the patients in observation group were less than those in control group(P<0.05).After the surgery,serum levels of interleukin(IL)-1,adrenocorticotropic hormone(ACTH),epinephrine(E)and norepinephrine(NE)in two groups were significantly higher,but those in observation group were significantly lower than those in control group(P<0.05).For excellent and good rate of therapeutic effect and the incidence of complications at the latest follow-up,there were no statistical differences between two groups(P>0.05).Conclusions Both external fixation and ORIF could obtain good short-term effects in the treatment of traumatic limb fractures.But when compared with ORIF,external fixator fixation has a beneficial effect on fracture healing,function recovery and hospitalization cost reduction,due to less intraoperative bleeding and lower severity of inflammatory reaction and stress response.
作者
易守红
周武平
何纯青
古浩然
杨鹏彬
赵卫军
YI Shouhong;ZHOU Wuping;HE Chunqing;GU Haoran;YANG Pengbin;ZHAO Weijun(Department of Surgery II,947 Hospital of PLA Army,Shule County,Xinjiang Uygur Autonomous Region 844200,China)
出处
《中国骨科临床与基础研究杂志》
2019年第2期99-103,共5页
Chinese Orthopaedic Journal of Clinical and Basic Research
