微创手术MIPO对肱骨干中段骨折患者术后创伤指标和骨代谢指标的影响

Effect of minimally invasive surgery MIPO on postoperative trauma indexes and bone metabolism indexes in patient with middle humeral shaft fracture

目的:分析微创手术MIPO对肱骨干中段骨折患者术后创伤指标和骨代谢指标的影响。方法:取2012年9月-2015年2月期间在武汉市汉口医院接受治疗的78例肱骨干中段骨折患者作为研究对象,根据接受的手术方式不同分为观察组及对照组各39例。对照组患者接受传统切开复位内固定治疗,观察组患者接受经皮微创钢板内固定技术(MIPO)治疗,对比两组患者的术后骨质量相关指标,酶学指标,补体、D-二聚体及血糖,骨代谢指标等水平差异。结果:观察组患者的治疗后Tb.Sp、BV/TV、ES值低于对照组患者,Tb.N、VOC值高于对照组患者(P<0.05);观察组患者的治疗后血清LDH、CK、CKMB、LDL、GPT、GOT值均低于对照组患者(P<0.05);观察组患者的治疗后C3、C4值高于对照组患者,Glu、GSP、D-D值低于对照组患者(P<0.05);观察组患者的治疗后BALP、BGP、PICP值高于对照组患者,PTH、TRACP-5b、CTX值低于对照组患者(P<0.05)。结论:肱骨干中段骨折患者接受微创手术MIPO治疗,术后创伤程度较轻、骨折愈合迅速。相较于传统切开复位内固定治疗,MIPO具有更多临床应用优势,值得在日后临床实践中推广应用。

Objective：To analyze the effect of minimally invasive surgery MIPO on postoperative trauma indexes and bone metabolism indexes in patient with middle humeral shaft fracture.Methods：A total of 78 patients with middle humeral shaft fracture who received treatment in our hospital from September 2012 to February 2015 were selected as research subjects and divided into observation group 39 cases and control group 39 cases according to different surgical methods.Control group received traditional open reduction and internal fixation treatment,observation group received minimally invasive plate osteosynthesis（MIPO）treatment,and then differences in the levels of postoperative bone quality-related indexes,enzyme parameters,complements,D-dimer as well as blood glucose and bone metabolism indexes were compared between two groups.Results：Tb.Sp,BV/TV and ES values of observation group after treatment were lower than those of control group while Tb.N and VOC values were significantly higher than those of control group（P〈0.05）;serum LDH,CK,CKMB,LDL,GPT and GOT values of observation group after treatment were significantly lower than those of control group（P〈0.05）;C3and C4 values of observation group after treatment were significantly higher than those of control group while Glu,GSP and D-D values were lower than those of control group（P〈0.05）;BALP,BGP and PICP values of observation group after treatment were significantly higher than those of control group while PTH,TRACP-5band CTX values were significantly lower than those of control group（P〈0.05）.Conclusions：Minimally invasive surgery MIPO treatment of patient with middle humeral shaft fracture is with lesser degree of postoperative trauma and rapid fracture healing.Compared with traditional open reduction and internal fixation treatment,MIPO has more clinical application advantages and is worth popularization and application in clinical practice in the future.