摘要
目的:比较交锁髓内钉固定术与钢板螺钉内固定术治疗四肢骨折伴骨不连患者的效果。方法:选取2020年5月至2023年3月该院收治的88例四肢骨折伴骨不连患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各44例。对照组采用钢板螺钉内固定术治疗,研究组采用交锁髓内钉内固定术治疗,比较两组临床疗效、围术期指标水平,手术前后创伤应激指标[肾上腺素(E)、β-内啡肽(β-EP)、皮质醇(Cor)]水平,以及术后并发症发生率。结果:研究组治疗优良率为95.45%(42/44),高于对照组的79.55%(35/44),差异有统计学意义(P<0.05);研究组骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3 d,两组E、β-EP、Cor水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:交锁髓内钉内固定术治疗四肢骨折伴骨不连患者可提高治疗效果,降低围术期指标水平、创伤应激指标水平和并发症发生率,其效果优于钢板螺钉内固定术治疗。
Objective:To compare effects of interlocking intramedullary nail fixation and plate-screw internal fixation in treatment of patients with limb fracture with nonunion.Methods:A prospective study was conducted on 88 patients with limb fractures with nonunion admitted to this hospital from May 2020 to March 2023.According to the random number table method,they were divided into study group and control group,44 cases in each group.The control group was treated with plate-screw internal fixation,while the study group was treated with interlocking intramedullary nail internal fixation.The clinical efficacy,the levels of perioperative indicators and the levels of traumatic stress indicators[epinephrine(E),β-endorphin(β-EP)and cortisol(Cor)]before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:The excellent and good rate of treatment in the study group was 95.45%(42/44),which was higher than 79.55%(35/44)in the control group,and the difference was statistically significant(P<0.05).The fracture healing time and the hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of E,β-EP and Cor in the two groups were lower than those before the surgery,those in the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Interlocking intramedullary nail internal fixation in the treatment of the patients with limb fractures and nonunion can improve the therapeutic effects and reduce the levels of perioperative indicators,the levels of traumatic stress indicators and the incidence of complications.Moreover,it is superior to plate-screw internal fixation.
作者
邹可以
袁孔
ZOU Keyi;YUAN Kong(Second Department of Orthopedics and Traumatology of Affiliated Hospital of Nanyang Medical College,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2024年第11期136-138,共3页
Medical Journal of Chinese People’s Health
关键词
交锁髓内钉内固定术
钢板螺钉内固定术
四肢骨折伴骨不连
创伤应激
并发症
Interlocking intramedullary nail internal fixation
Plate-screw internal fixation
Limb fracture with nonunion
Traumatic stress
Complication
