经皮微创钢板内固定术治疗胫骨骨折患者的效果

Effects of minimally invasive percutaneous plate internal fixation in treatment of patients with tibial fractures

目的:观察经皮微创钢板内固定术治疗胫骨骨折患者的效果。方法:选取2019年4月至2021年4月该院收治的60例胫骨骨折患者进行前瞻性研究,以随机数字表法将其分为对照组和研究组各30例。对照组采用传统切开复位内固定术治疗,研究组采用经皮微创钢板内固定术治疗,比较两组围术期指标水平、临床疗效、手术前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6和IL-8]水平、术后1周并发症发生率和手术前后生命质量[健康状况调查简表(SF-36)]评分。结果:研究组术中出血量少于对照组,手术时间、骨折愈合时间和住院时间均短于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率为93.33%(28/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05);术后24 h,两组TNF-α、IL-6和IL-8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为6.66%(2/30),低于对照组的30.00%(9/30),差异有统计学意义(P<0.05);术后6周,两组SF-36评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:经皮微创钢板内固定术治疗胫骨骨折患者可改善围术期指标水平,提高治疗总有效率和生命质量评分,降低炎性因子水平和并发症发生率,效果优于传统切开复位内固定术治疗。

Objective:To observe effects of minimally invasive percutaneous plate internal fixation in treatment of patients with tibial fractures.Methods:The clinical data of 60 patients with tibial fractures admitted to this hospital from April 2019 to April 2021 were retrospectively studied.They were divided into control group and study group by using the random number table method,30 cases in each.The control group was treated with traditional open reduction and internal fixation,while the study group was treated with minimally invasive percutaneous plate internal fixation.The perioperative index levels,the clinical efficacy,the levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-8]before and after the operation,the incidence of complications 1 week after the operation,and the quality of life[health survey(SF-36)]scores before and after the operation were compared between the two groups.Results:The intraoperative blood loss in the study group was less than that in the control group;the operation time,the fracture healing time and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).The total effective rate of treatment in the study group was 93.33%(28/30),which was higher than 73.33%(22/30)in the control group,and the difference was statistically significant(P<0.05).24 h after operation,the levels of TNF-α,IL-6 and IL-8 in the two groups were higher than those before the operation,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the study group was 6.66%(2/30),which was lower than 30.00%(9/30)in the control group,and the difference was statistically significant(P<0.05).Further,6 weeks after the operation,the SF-36 scores of the two groups were higher than those before the operation,that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusions:Minimally invasive percutaneous plate internal fixation for the patients with tibial fractures can improve the levels of perioperative indicators,improve the total effective rate of treatment and the quality of life scores and reduce the levels of inflammatory factors and the incidence of complications.Moreover,it is superior to traditional open reduction and internal fixation.