2种治疗方法对闭合性胫骨干骨折疗效及患者术后生活质量的影响

Efficacy and influence of the two methods on the closed tibial shaft fractures and the quality of life after operation

目的探讨微创钢板固定(MIPO)与交锁髓内钉固定治疗对闭合性胫骨干骨折疗效及患者术后生活质量的影响。方法选择2013年5月-2014年7月在新疆乌鲁木齐市第一人民医院骨科应用微创钢板固定和交锁髓内钉方法治疗闭合性胫骨干骨折患者93例,其中应用微创钢板固定48例(微创钢板固定组)和交锁髓内钉45例(交锁髓内钉组)。比较两组患者的临床疗效、手术时间、住院时间、出血量、愈合时间、术中透视次数及术后并发症,并分析患者术后生活质量。结果微创钢板固定组患者手术时间、术中透视次数明显少于交锁髓内钉组患者,差异有统计学意义(P<0.05);而住院时间、出血量和愈合时间、临床疗效差异无统计学意义(P>0.05);微创钢板固定组患者术后并发症发生率(12.5%)明显低于交锁髓内钉组患者(28.9%)(P<0.05);微创钢板固定组患者在心理健康、躯体功能、情绪角色、躯体角色社会功能、疼痛、活力和总健康赋分方面明显高于交锁髓内钉组患者(P<0.05)。结论微创钢板固定与交锁髓内钉治疗闭合性胫骨骨折均有较好临床疗效;而术后微创钢板固定患者术后生活质量更高,优于交锁髓内钉固定患者,值得临床推广。

Objective To explore the clinical effect and life quality of minimally invasive plate fixation and intramedullary interlocking nail in closed tibia shaft fracture patients. Methods 93 cases of patients which applied micro creates the steel plate to be fixed and junction locks in the marrow the nail method treatment closed shin backbone bone fracture were chose in the department of orthopedics in Xinjiang Urumqi first People＇s Hospital during May 2013 and July 2014,in which 48 cases of patients applied minimal invasive procedure（ the minimal invasive procedure group） and 45 cases of patients applied intramedullary interlocking nail（ the inreamedullary interlocking nail group）. The two groups of patients＇ clinical efficacy,operative time,the length of stay,bleeding volume,healing time,frequency of hemodialysis during the operation and postoperative complications were compared and their quality of life after the operation were analyzed. Results Minimally invasive plate fixation group operation time,intraoperative fluoroscopy times are significantly less than the interlocking intramedullary nail group,with significant difference（ P〈0. 05）; and in hospital time,amount of bleeding,and the healing time of the clinical curative effect of no significant difference（ P〈0. 05）; minimally invasive plate fixation group complication rate was 12. 5%,interlocking intramedullary nail group was 28. 9%,two group of comparison,were significantly lower than the interlocking intramedullary nail group complications of minimally invasive plate fixation（ P〈0. 05）; and in the quality of life of psychological health,physical function,role emotional,social function,role physical pain,vitality and general health scores of minimally invasive plate fixation group was significantly higher than that of interlocking intramedullary nail group（ P〈0. 05）. Conclusion Minimally invasive plate fixation and intramedullary nail were consistent with biological fixation,treatment of closed tibial fractures achieved with good results,and the postoperative quality of life of minimally invasive plate fixation is better,and worth the clinical promotion.