摘要
目的:探讨两种固定术在多发伤伴胫腓骨开放性骨折急救中的应用效果及对骨折愈合的影响。方法:选取2020年1月-2021年1月佳木斯市中心医院收治的85例多发伤伴胫腓骨开放性骨折患者,依据固定术治疗方式的不同分为A组(n=42)和B组(n=43)。A组予以加压钢板内固定术治疗,B组予以交锁髓内钉固定术治疗。比较两组救治效果、手术指标与骨折愈合情况、炎症因子[白细胞计数(WBC)、C反应蛋白(CRP)]与红细胞沉降率(ESR)、骨代谢[骨钙素(BGP)、碱性磷酸酶(ALP)及Ⅰ型胶原羧基端肽β特殊序列(β-CTX)]水平。结果:治疗后,B组救治优良率为93.02%,高于A组的76.19%,差异有统计学意义(P<0.05)。B组切口长度、手术操作时间、住院时间、创面愈合时间及骨折愈合时间均短于A组,差异均有统计学意义(P<0.05)。术后48 h,两组WBC、ESR及CRP水平均高于术前,且B组均低于A组,差异均有统计学意义(P<0.05)。术后30 d,两组BGP、ALP水平均高于术前,β-CTX水平均低于术前,且B组BGP及ALP水平均高于A组,而β-CTX水平低于A组,差异均有统计学意义(P<0.05)。结论:与加压钢板内固定术比较,交锁髓内钉固定术可提升多发伤伴胫腓骨开放性骨折患者的急诊救治效果,改善手术指标,并且改善炎症因子表达及骨代谢水平,促进骨折愈合。
Objective:To study the application effect of two kinds of fixation in the treatment of multiple injuries with open tibiofibular fractures and its influence on fracture healing.Method:A total of 85 patients with multiple injuries and open tibiofibular fractures treated in the Central Hospital of Jiamusi City from January 2020 to January 2021 were selected,they were divided into group A (n=42) and group B (n=43) according to the different treatment methods of fixation.Group A was treated with compression plate internal fixation,and group B was treated with interlocking intramedullary nail fixation.The treatment effect,surgical indicators,fracture healing,inflammatory factors[white blood cell count (WBC),C reactive protein (CRP)]and erythrocyte sedimentation rate (ESR),bone metabolism[osteocalcin (BGP),alkaline phosphatase (ALP) and special sequence of carboxy-terminal peptide β of type Ⅰ collagen (β-CTX)]were compared between two groups.Result:After treatment,the overall excellent treatment rate of the group B was 93.02%,which was higher than 76.19% of the group A,the difference was statistically significant (P<0.05).The incision length,operation time,hospital stay,wound healing time and fracture healing time in the group B were shorter than those in the group A,the differences were statistically significant (P<0.05).48 h after operation,WBC,ESR and CRP levels in both groups were higher than those before operation,and those in the group B were lower than those in the group A,the differences were statistically significant (P<0.05).30 d after operation,the levels of BGP and ALP in both groups were higher than those before operation,and the levels of β-CTX in both groups were lower than those before operation,the levels of BGP and ALP in the group B were higher than those in the group A,while the level of β-CTX in the group B was lower than that in the group A,the differences were statistically significant (P<0.05).Conclusion:Compared with compression plate internal fixation,interlocking intramedullary nail fixation can improve the emergency treatment of patients with multiple injuries and open tibiofibular fractures,improve surgical indicators,as well as improve the expression of inflammatory factors and bone metabolism,and promote fracture healing.
作者
张宏宇
ZHANG Hongyu(The Central Hospital of Jiamusi City,Heilongjiang Province,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2022年第11期5-9,共5页
Medical Innovation of China
关键词
加压钢板内固定术
交锁髓内钉固定术
多发伤
胫腓骨开放性骨折
骨折愈合
Compression plate internal fixation
Interlocking intramedullary nail fixation
Multiple injuries
Open tibiofibular fractures
Fracture healing
