摘要
目的:探讨微创经皮钢板内固定(MIPPO)治疗胫骨远端骨折效果及对患者应激状态的影响。方法:选取2019年1月-2021年1月于佳木斯市中心医院骨外科住院治疗的80例胫骨远端骨折患者,根据治疗方式的差异将患者分为两组,MIPPO组(n=42)接受微创经皮钢板内固定治疗,交锁髓内钉(IMN)组(n=38)接受交锁髓内钉治疗。比较两组围手术期相关指标、骨折愈合时间、并发症发生情况及治疗效果。比较两组术前及术后3 d的应激状态指标,包括血清P物质(SP)、前列腺素E_(2)(PGE_(2))、C反应蛋白(CRP)及超氧化物歧化酶(SOD)。结果:MIPPO组手术时间及透视时间均短于IMN组,术中失血量少于IMN组,差异均有统计学意义(P<0.05)。两组骨折愈合时间比较,差异无统计学意义(P>0.05)。MIPPO组优良率为95.24%,高于IMN组的92.11%,但差异无统计学意义(P>0.05),MIPPO组整体疗效优于IMN组,差异有统计学意义(P<0.05)。术前,两组SP、PGE_(2)、CRP、SOD比较,差异均无统计学意义(P>0.05);术后3 d,两组SP、PGE_(2)、CRP均高于术前,SOD均低于术前,且MIPPO组SP、PGE_(2)、CRP均低于IMN组,SOD高于IMN组,差异均有统计学意义(P<0.05)。MIPPO组并发症发生率低于IMN组,差异有统计学意义(P<0.05)。结论:与IMN治疗相比,胫骨远端骨折患者采用MIPPO具有更好的疗效及安全性,且应激反应较轻。
Objective:To investigate the effect of minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of distal tibial fractures and its influence on stress state.Method:A total of 80 patients with distal tibial fractures hospitalized in the Department of Orthopedics,Jiamusi Central Hospital from January 2019 to January 2021 were selected,according to the differences in treatment methods,the patients were divided into two groups,MIPPO group(n=42)received minimally invasive percutaneous plate osteosynthesis,and IMN group(n=38)received interlocking intramedulmonary nail treatment.Perioperative indicators,fracture healing time,complications and therapeutic effects were compared between two groups.The stress state indexes,including serum substance P(SP),prostaglandin E_(2)(PGE_(2)),C reactive protein(CRP)and superoxide dismutase(SOD)were compared between two groups before and 3 d after operation.Result:The operative time and fluoroscopy time of the MIPPO group were shorter than those of the IMN group,and the intraoperative blood loss of the MIPPO group was less than that of the IMN group,the differences were statistically significant(P<0.05).There was no significant difference in fracture healing time between two groups(P>0.05).The excellent and good rate of the MIPPO group was 95.24%,which was higher than 92.11%of the IMN group,but the difference was not statistically significant(P>0.05).The overall efficacy of the MIPPO group was better than that of the IMN group,the difference was statistically significant(P<0.05).Before operation,there were no significant differences in SP,PGE_(2),CRP and SOD between two groups(P>0.05);3 d after operation,SP,PGE_(2) and CRP of both groups were higher than those before operation,while SOD of both groups were lower than those before operation,SP,PGE_(2) and CRP of the MIPPO group were lower than those of the IMN group,while SOD of the MIPPO group was higher than that of the IMN group,the differences were statistically significant(P<0.05).The incidence of complications
作者
刘大伟
LIU Dawei(Jiamusi Central Hospital,Heilongjiang Province,Jiamusi 154002,China)
出处
《中国医学创新》
CAS
2022年第26期20-24,共5页
Medical Innovation of China
关键词
微创经皮钢板内固定
胫骨远端骨折
应激状态
Minimally invasive percutaneous plate osteosynthesis
Distal tibial fractures
Stress state
