摘要
目的:研究微创踝关节融合术治疗老年创伤性踝关节炎中的临床效果及对患者氧化损伤与骨代谢的影响。方法:收集2014年3月至2015年3月我院收治的94例老年创伤性踝关节炎患者,按随机数表法分为实验组和对照组,每组各45例。两组患者在手术前均进行常规检查,对照组采用常规开放式踝关节融合术,实验组采用微创踝关节融合术。对比两组治疗后血清氧化损伤指标肌红蛋白(MYO)、缺血修饰白蛋白(IMA)、总抗氧化能力(TAC)、丙二醛(MDA)水平,骨代谢指标碱性磷酸酶(ALP)、酸性磷酸酶(ACP)、甲状旁腺素(PTH)、骨钙素(BGP)、降钙素(CT)水平,视觉疼痛模拟评分(VAS)、美国矫形外科足踝协会(AOFAS)评分及不良反应的发生情况。结果:治疗后,实验组血清MYO、IMA、MDA水平显著低于对照组[(20.48±2.59)ng/mL vs.(27.07±2.97)ng/m L,(65.68±8.20)U/L vs.(74.27±9.01)U/L,(5.01±1.03)nmol/L vs.(9.64±2.17)nmol/L](P<0.05),血清TAC水平显著高于对照组[(11.40±2.50)kU/L vs.(7.36±1.03)kU/L](P<0.05);血清ALP、BGP、CT水平均显著高于对照组[(103.28±12.47)U/L vs.(90.53±10.02)U/L,(11.08±1.42)ng/L vs.(8.01±1.23)ng/L,(61.39±5.87)ng/L vs.(50.28±4.92)ng/L](P<0.05),ACP、PTH水平均显著低于对照组[(5.21±0.60)U/L vs.(8.03±0.92)U/L,(42.95±5.38)ng/L vs.(60.49±6.92)ng/L](P<0.05);VAS评分显著低于对照组[(1.06±0.23)分vs.(3.79±0.67)分](P<0.05),AOFAS评分显著高于对照组[(73.02±6.28)分vs.(65.58±5.13)分](P<0.05);不良反应总发生率显著低于对照组[6.66%(3/45) vs. 20.41%(10/49)](P<0.05)。结论:微创踝关节融合术可调节老年创伤性踝关节炎患者的骨代谢,增强骨密度,减少术后不良反应,有利于改善患者预后。
Objective：To study clinical effect of minimally invasive ankle arthrodesis for elderly patients with traumatic ankle arthritis and its effects on oxidative damage and bone metabolism.Methods：94 cases of elderly patients with traumatic ankle arthritis treated in our hospital were selected as the research objects.According to the random number table,they were divided into the control group and the experimental group,with 45 cases in each group.Routine examinations were performed before operation in the two groups,the control group was treated with conventional open ankle arthrodesis,while the experimental group was treated with minimally invasive ankle arthrodesis.The levels of MYO,IMA,TAC,MDA,bone metabolism index alkaline phosphatase（ALP）,acid phosphatase（ACP）,parathyroid hormone（PTH）,osteocalcin（BGP）,calcitonin（CT）,and visual pain analogue score（VAS）,Orthopaedic foot and ankle Association（AOFAS） score and adverse reactions in the US were compared between the two groups after treatment.Results：After treatment,The levels of serum MYO,IMA and MDA in the experimental group were significantly lower than those in the control group [（20.48±2.59） ng/mL vs.（27.07±2.97） ng/mL,（65.68±8.20） U/L vs.（74.27±9.01） U/L,（5.01±1.03） nmol/L vs.（9.64±2.17）nmol/L]（P〈0.05）,The level of serum TAC was significantly higher than that of the control group [（11.40±2.50）kU/L vs.（7.36±1.03）k U/L]（P〈0.05）;The level of serum ALP,BGP and CT was significantly higher than that of the control group [（103.28±12.47） U/L vs.（90.53±10.02） U/L,（11.08±1.42） ng/L vs.（8.01±1.23） ng/L,（61.39±5.87） ng/L vs.（50.28±4.92） ng/L]（P〈0.05）,The levels of ACP and PTH were significantly lower than those in the control group [（5.21±0.60）U/L vs.（8.03±0.92）U/L,（42.95±5.38）ng/L vs.（60.49±6.92）ng/L]（P〈0.05）;VAS score was lower than the control group [（1.06±0.23） vs.（3.79±0.67）]（P〈0.05）,AOFAS score was higher tha
作者
罗程
梁俊生
冯志杰
张辉良
龚建
LUO Cheng;LIANG Yun-sheng;FENG Zhi-jie;ZHANG Hui-liang;GONG Jian(The elderly Department of orthopedics,Second Hospital of Tangshan,Hebei,Tangshan,063008,China;Department of orthopedics,Affiliated Hospital of North China University of science and technology,Tangshan,Hebei,063008,China)
出处
《现代生物医学进展》
CAS
2018年第18期3584-3588,共5页
Progress in Modern Biomedicine
基金
河北省2014年度医学科学研究课题计划项目(ZL2014167)
关键词
微创踝关节融合术
创伤性踝关节炎
术后创伤
骨代谢
Minimally invasive ankle arthrodesis
Traumatic ankle osteoarthritis
Postoperative trauma
Bone metabolism
