不同方案治疗胫腓骨骨折早期肿胀疼痛疗效观察

Clinical study of different regimens in the treatment of early swelling and pain of tibiofibular fracture

目的观察不同治疗方法对胫腓骨骨折早期所致肢体肿胀、疼痛的治疗效果,以期为临床上胫腓骨骨折治疗方法的选择提供依据。方法将2015年1月至2017年8月期间广州中医药大学附属新会中医院骨伤科收治的90例胫腓骨骨折患者按随机数表法分为A、B、C共三组各30例,A组给予20%甘露醇静滴、B组注射用血塞通静滴、C组小剂量甘露醇+注射用血塞通静滴疗法。疗程均为7 d。比较三组患者的肿胀消失或缓解时间、疼痛消失或缓解时间,并比较临床疗效。结果 A、B、C三组患者的治疗总有效率分别为73.3%、76.7%和90.0%,C组治疗总有效率明显高于A组、B组,差异有统计学意义(P<0.05);C组患者肿胀消失或缓解时间、疼痛消失或缓解时间分别为(2.60±0.92)d、(2.67±0.81)d,均低于A、B组的(5.27±2.86)d、(4.33±1.89)d和(4.83±1.95)d、(3.89±1.07)d,差异均有统计学意义(P<0.05)。结论小剂量甘露醇联合血塞通注射液对胫腓骨骨折早期所致肢体肿胀、疼痛等症状具有良好的改善作用,疗效优于单用甘露醇或血塞通,具有临床推广价值。

Objective To observe the effect of different treatment methods on limb swelling and pain in the early stage of tibiofibular fracture, and to provide basis for the selection of treatment methods for tibiofibular fractures in clinic. Methods From Jan. 2015 to Aug. 2017, 90 patients of tibiofibular fractures treated in Department of Orthopedics and Traumatology, Xinhui Traditional Chinese Medicine Hospital of Guangzhou University of Chinese Medicine were divided into 3 groups： group A, group B and group C, each with 30 cases. Patients in the three groups were treated by intravenous drip of 20% mannitol, Xuesaitong injection, low-dose mannitol combined with Xuesaitong injection, respectively, for 7 d. The clinical efficacy of the 3 groups were observed, and the swelling disappeared or remission time,pain disappeared or remission time were recorded. Results The total effective rate of group C was 90.0%, significantly higher than 73.3% in group A, and 76.7% in group B（P〈0.05）. In group C, the swelling disappeared or remission time,pain disappeared or remission time were（2.60 ± 0.92） d,（2.67 ± 0.81） d, significantly lower than（5.27 ± 2.86） d,（4.33 ±1.89） d in group A and（4.83±1.95） d,（3.89±1.07） d in group B（P〈0.05）. Conclusion Low-dose mannitol combined with Xuesaitong injection can improve the symptoms of limb swelling and pain caused by tibiofibular fracture at early stage, and the curative effect is better than mannitol or Xuesaitong alone.