摘要
目的探讨高压氧(HBO)综合治疗对胫骨骨折患者术后愈合及骨性标志物水平的影响。方法选取2017年9月至2018年6月宁夏医科大学总医院创伤骨科就诊的需要手术治疗胫骨骨折患者100例。按照随机数字表法分为对照组和观察组,每组50例。对照组患者均接受微创钢板接骨术和骨科术后常规治疗,观察组患者在对照组基础上加用HBO治疗。比较2组患者术后临床疗效、血清骨性标志物指标水平、骨折愈合的时间和疼痛消失的时间、骨折区骨密度水平和生活质量评分。结果观察组患者术后优良率(90.0%)明显高于对照组(68.0%),差异有统计学意义(P<0.05);治疗2个疗程后,与治疗前比较,观察组组患者总骨Ⅰ型前胶原氨基端延长肽(Total-PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平明显降低,降钙素(CT)、Ⅰ型前胶原羧基端肽(PICP)、骨钙素(BGP)明显升高,差异均有统计学意义(P<0.05);观察组治疗后Total-PINP、β-CTX明显低于对照组,CT、PICP、BGP明显高于对照组,差异有统计学意义(P<0.05)。观察组患者骨折愈合时间和疼痛消失时间显著少于对照组(P<0.05);出院后6个月观察组患者骨折区骨密度显著高于对照组(均P<0.05),观察组SF-36表各指标评分均高于对照组(均P<0.05)。结论微创钢板接骨术后加用HBO治疗能促进胫骨骨折患者的骨折愈合,显著调节骨性标志物各指标水平,提高患者生活质量。
Objective To investigate the effects of hyperbaric oxygen(HBO)on postoperative healing and the expression level of osseous markers in tibial fracture patients.Methods One hundred patients with tibia fracture who required surgery in the hospital from September 2017 to June 2018 were enrolled for study and were randomly divided into the control group and the observation group,each consisting of 50 patients.The patients in both groups received routine treatment after minimally invasive plate osteosynthesis and orthopedic surgery,and the patients in the observation group were supplemented with HBO therapy in addition to the treatment as received by the control group.Then,postoperative clinical efficacy,serum osseous marker levels,time of fracture healing and time of pain disappearance,bone mineral density at the fracture site and scores of life quality were compared between the patients of the 2 groups.Results The excellent rate of treatment in the observation group was as high as 90.00%,which was significantly better than that in the control group(68.00%),with statistical significance(P<0.05).After 2 courses of treatment,total boneⅠbefore collagen amino terminal extension of the peptide(Total-PINP)and the levels of collagen typeⅠcarboxyl end peptide beta sequence(β-CTX)of the observation group significantly lowered as compared with those before treatment,while the levels of calcitonin(CT),Ⅰbeta special type collagen carboxyl end before peptide(PICP)and osteocalcin(BGP)significantly increased,also with statistical significance(P<0.05).The levels of Total-PINP andβ-CTX in the observation group after treatment were obviously lower than those of the control group,also with statistical significance(P<0.05).The time of fracture healing and the time of pain disappearance in the observation group were all significantly shorter than those in the control group(P<0.05).Six months after discharge from hospital,bone mineral density(BMD)of the observation group was markedly higher than that of the control group(P<0.05).The results showed that the SF-36 scores of the observation group were higher than those of the control group(P<0.05).Conclusion After minimally invasive plate osteosynthesis,the application of HBO could promote fracture healing,significantly regulate the levels of bone markers and improve life quality of the patients with tibial fracture.
作者
伯宇
金云
臧园
杨海波
Bo Yu;Jin Yun;Zang Yuan;Yang Haibo(Department of Trauma and Orthopaedics of General Hospital Affiliated to Ningxia Medical University,Yinchuan 750004,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2019年第6期583-587,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
