摘要
目的:比较微创经皮锁定加压钢板内固定术与切开复位内固定术治疗胫骨平台骨折患者的效果。方法:选取2020年1月至2023年1月该院收治的86例胫骨平台骨折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43例。对照组采用切开复位内固定术治疗,研究组采用微创经皮锁定加压钢板内固定术治疗,比较两组临床疗效、围术期指标水平、术后膝关节功能[Lysholm膝关节功能量表(LKS)]评分、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、术后并发症发生率。结果:研究组治疗优良率为95.35%(41/43),高于对照组的79.07%(34/43),差异有统计学意义(P<0.05);研究组切口长度、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);研究组LKS评分、膝关节最大伸膝、屈膝角度均高于对照组,差异有统计学意义(P<0.05);术后7 d,两组E、β-EP、Cor水平均高于术前,但研究组低于对照组,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:微创经皮锁定加压钢板内固定术治疗胫骨平台骨折患者可提高治疗优良率和膝关节功能恢复指标水平,降低应激反应指标水平和并发症发生率,其效果优于切开复位内固定术治疗。
Objective:To compare effects of minimally invasive percutaneous locking compression plate internal fixation and open reduction and internal fixation in treatment of patients with tibial plateau fractures.Methods:A prospective study was conducted on 86 patients with tibial plateau fractures admitted to this hospital from January 2020 to January 2023.According to the random number table method,they were divided into study group and control group,43 cases in each group.The control group was treated with open reduction and internal fixation,while the study group was treated with minimally invasive percutaneous locking compression plate internal fixation.The clinical efficacy,the perioperative index levels,the postoperative knee joint function[Lysholm knee function scale(LKS)]score,the preoperative and postoperative traumatic stress indexes[epinephrine(E),β-endorphin(β-EP),cortisol(Cor)]levels,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 95.35%(41/43),which was higher than 79.07%(34/43)in the control group,and the difference was statistically significant(P<0.05).The incision length,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).The LKS score,the maximum knee extension and knee flexion angle levels of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).Seven days after the surgery,the levels of E,β-EP and Cor in the two groups were higher than those before the surgery,but those in the study group were lower than those in 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(
作者
李学锋
Li Xuefeng(Department of Orthopaedics of Jia County People’s Hospital,Pingdingshan 467100 Henan,China)
出处
《中国民康医学》
2024年第18期147-150,共4页
Medical Journal of Chinese People’s Health
关键词
微创经皮锁定加压钢板内固定术
切开复位内固定术
胫骨平台骨折
关节活动度
关节功能
创伤应激
并发症
Minimally invasive percutaneous locking compression plate internal fixation
Open reduction and internal fixation
Tibial plateau fracture
Joint range of motion
Joint function
Traumatic stress
Complication
