膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、sVCAM和ALP水平的影响.docx
《膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、sVCAM和ALP水平的影响.docx》由会员分享,可在线阅读,更多相关《膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、sVCAM和ALP水平的影响.docx(6页珍藏版)》请在课桌文档上搜索。
1、膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、SVCAM和ALP水平的影响何鹏马拓*杜俊伟王斌石海浪西电集团医院骨科陕西西安710077通讯作者:马拓。摘要目的研究膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清神经生长因子(NGF)、血管细胞黏附因子(SVCAM),碱性磷酸酶(ALP)水平的影响。方法选择2019年2月至2020年2月我院60例胫骨平台骨折患者进行研究。按照简单抽签法分为研究组和对照组,各30例,对照组采用传统切开复位内固定术治疗,研究组采用膝关节镜下有限切开骨折庭位内固定术治疗。比较两组治疗3个月后治疗优良率,术后恢复情况(手术切口
2、长度、骨折愈合时间、关节活动度),治疗前及治疗3个月后Rasmussen和VAS评分、血清NGF、SVCAM和ALP水平,记录分析两组住院期间的并发症发生率。结果研究组的治疗优良率为86.66%,明显高于对照组的60.00%,差异有统计学意义(P0.05);研究组切口长度、手术时间、术中出血量、术后引流软、卜床时间分别为(7.85l.40)cm,(81.908.46)min,(78.6016.2l)ML,(31.293.28)d,(3.670.85)d均明显低于对照组I(15.603.91)cm,(107.56l1.87)min,(96.3OI9.32)ML,(41.896.23)d,(5.1
3、81.20)d,差异有统计学意义(PVO.05);研究组手术切口长度、骨折愈合时间分别为(5.811.23)cm、(3.100.52)月,均明显短于对照组的(19.023.6DCm、(5.890.7l)月,研究组的关节活动度为(126.75+15.62)。,明显高于对照组的(118.63+13.29),差异有统计学意义(PVo.05);研究组RaSmUSSen评分为(95.036.87)分,明显高于对照组的(82.654.32)分,差异具有统计学意义(PVO.05);研究组VAS评分为(3.090.52)分,明显低于对照组的(5.6l1.03)分,差异具有统计学意义(PVO.05);研究组NG
4、F、ALP水平分别为(1.360.32)mgL.(275.8660.32)U/L,均明显高于对照组的(0.890.27)mgL.(I9O.7647.69)U/L,差异有统计学意义(PVO.05);研究组并发症发生率为3.33%,明显低于对照组23.33%,差异有统计学意义(PVO.05).结论膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效显著,可促进骨愈合,减轻炎症因子NGF、sVCAM.ALP水平,降低术后并发症,利于术后早期功能锻炼.【关键词】膝关节镜下;有限切开骨折复位内固定术;胫骨平台骨折;炎症反应;并发症Theeffectoflimitedincisionfracturer
5、eductionandinternalfixationunderarthroscopyontibialplateaufractureandtheinfluenceonserumNGF,sVCAMandALPlevelsHepengmatuo*dujunweiwangbinShihailangDepartmentofOrthopedicsXidianHospitalShanxiXi,an710077AbstractObjectiveTostudytheeffectoflimitedincisionfracturereductionandinternalfixationunderarthrosco
6、pyontibialplateaufractureandtheinfluenceonserumNGF,sVCAMandALPlevels.Methods60patientswithtibialplateaufracturewhoreceivedtreatmentinourhospitalfromFebruary2018toFebruary2020wereselectedforthisstudy.Theyweredividedintostudygroupandcontrolgroupwith30casesineachgroup.Thecontrolgroupwastreatedwithtradi
7、tionalopenreductionandinternalfixation,Thestudygroupwastreatedwithlimitedopenreductionandinternalfixationunderkneearthroscope.Theexcellentrate,postoperativerecovery(incisionlength,fracturehealingtime,jointactivity)werecomparedinthetwogroupsafter3months,andtheRasmussenandVASscores,serumNGF,sVCAMandAL
8、Plevelswerecomparedbeforeandafter3months,theincidenceofcomplicationsinthetwogroupsduringhospitalizationwasrecordedandanalyzed.ResultsTheexcellentandgoodrateofthestudygroupwas86.66%,whichwassignificantlyhigherthanthatofthecontrolgroup60.00%,thedifferencewasstatisticallysignificant(P0.05);Theincisionl
9、ength,operationtime,intraoperativebleeding,postoperativedrainagevolumeandoutofbedtimeinthestudygroupwere(7.851.40)cm,(81.908.46)min,(78.6016.21)ML,(31.293.28)d,(3.670.85)djwassignificantlylowerthanthecontrolgroup(15.603.91)cm,(107.56l1.87)min,(96.3019.32)ML,(41.896.23)d,(5.I81.2O)d,thedifferencewass
10、tatisticallySignifiCant(PVo.05)helengthofincisionandfracturehealingtimeofthestudygroupwere(5.811.23)cm,(3.100.52)month,whichwassignificantlyshorterthanthatofthecontrolgroup(19.023.61)cm,(5.890.71)month,therangeofmotionofthestudygroupwas(126.7515.62),whichwassignificantlyhigherthanthatofthecontrolgro
11、up(118.6313.29),thedifferencewasstatisticallysignificant(P0.05);therasmussenscoreofthestudygroupwas(95.036.87)scores,whichwassignificantlyhigherthanthatofthecontrolgroup(82.654.32)scores,thedifferencewasstatisticallysignificant(P0.05);theVASscoreofthestudygroupwas(3.090.52)scoreswassignificantlyshor
12、terthanthatofthecontrolgroup(5.6l1.03)scores,thedifferencewasstatisticallysignificant(P0.05);thelevelsofNGFandALPinthestudygroupwere(1.360.32)mgL,(275.8660.32)UUWaSsignificantlyhigherthanthatofthecontrolgroup(0.890.27)mgL,(190.7647.69)UL,thedifferencewasstatisticallysignificant(P0.05);theincidenceof
13、complicationsinthestudygroupwas3.33%,whichwassignificantlylowerthanthatofthecontrolgroup23.33%,thedifferencewasstatisticallysignificant(P0.05),见表1。表1两组一般资料对比Us)组例性别年龄受伤SChatZker分型致伤原因合并损伤别数(男/(岁)至入I型H型In型扭摔交半月前交叉内侧女)院时伤伤通板游韧带胫副韧间(d)事离侧止点带断故撕脱裂研3017/1341.896.02l1017359161578究1.32.03组对3018/1241.986.53
14、11115438191686照八、1.35.21组tx20.0690.2611.7580.3160.8160.385值P0.7930.7950.0840.8540.6650.825值1.2方法对照组采用传统内固定术治疗,(1)于术中翻起皮下组织和皮肤,切开关节囊,若发现半月板已出现损伤,若损伤情况不严重可予以保留;(2)随后切开半月板冠状韧带,将半月板掀起,充分暴露胫骨平台关节面,翘起塌陷的关节面,保持胫骨踝骨块和塌陷的关节面在同一平面上;(3)观察骨折端复位情况。研究组在膝关节镜辅助下,采用有限切开骨折复位内固定术进行治疗,首先进行膝关节镜检查,评估患者关节软骨和半月板的损伤状况,根据不同S
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 膝关节 有限 切开 骨折 复位 固定 治疗 胫骨 平台 疗效 血清 NGF sVCAM ALP 水平 影响
链接地址:https://www.desk33.com/p-564408.html