研究不同时间体外冲击波疗法治疗骨不连的临床疗效

Study on Clinical Efficacy of Extracorporeal Shock Wave Therapy for Nonunion in Different Time

目的探析不同时间体外冲击波疗法治疗骨不连的临床疗效,旨在寻找一种有效的非手术骨不连治疗手段。方法便利收集2013年10月—2015年6月期间该院门诊及住院部收诊的200例内固定术骨不连患者作为研究对象,所有患者及其家属均对此次研究知情同意,且研究已获得该院伦理委员会批准,根据骨不连不同临床治疗方式将患者分为A组(40例),采用手术式治疗;其他160例(B组)手术处理后均接受体外冲击波疗法治疗,根据不同治疗时间又细分为B1(2周)、B2(4周)、B3(8周)、B4(12周)4个小组,病例数均为40例,同A组相比观察不同时间体外冲击波疗法治疗效果差异。结果治疗后B组的4个小组患者骨折处间隙宽度均较A组更窄(P<0.05),且B1、B2、B3、B4 4组病例从前到后骨折间隙宽度呈增大趋势;3个疗程观察期内B1、B2、B3、B4 4小组患者愈合优良率均高于A组(P<0.05),且B1、B2、B3、B4 4组病例从前到后3个疗程愈合优良率呈降低趋势;B组患者愈合时间(6.8±4.6)个月明显短于A组的(10.2±5.5)个月(t=4.014,P=0.000)。结论同单纯传统手术治疗方式相比,早期越早对骨不连患者应用体外冲击波疗法,可进一步加快骨折处愈合速度,缩短康复进程,临床应用价值高。

Objective To investigate the clinical efficacy of extracorporeal shock wave therapy in the treatment of nonunion at different time, in order to find an effective non-operative nonunion treatment. Methods Convenient select a total of 200 patients with internal fixation and nonunion who were admitted to the outpatient and inpatient departments from October 2013 to June 2015 were enrolled. All patients and their families gave informed consent for this study. Approved by the ethics committee, patients were divided into group A （40 cases） according to different clinical treatment methods of nonunion, and surgical treatment was used. The other 160 cases （group B） were treated with extracorporeal shock wave therapy after surgery. The treatment time was subdivided into four groups： B1 （2weeks）, B2 （4 weeks）, B3 （8 weeks）, and B4 （12 weeks）. The number of eases was 40. Compared with group A, extracorporeal shock wave therapy, difference in treatment effect was observed at different times. Results After treatment, the width of the fractures in the four groups of patients in group B were narrower than those in group A（P〈0.05）, and the width of fractures in the four groups of B1, B2, B3 and B4 increased from front to back. The excellent and good rate of healing in group B1, B2, B3 and B4 in the three treatment pe riods was higher than that in group A（P〈0.05）, and the excellent rate of healing in the four groups of B1, B2, B3 and B4 from before to after treatment was reduced; the healing time of group B （6.8 ± 4.6） months was significantly shorter than that of group A （10.2 ± 5.5） months （t= 4.014, P= 0.000）. Conclusion Compared with traditional surgical treatment, early appli- cation of extracorporeal shock wave therapy to patients with nonunion early can further accelerate the healing rate of fi＇ac- tures, shorten the recovery process, and have high clinical application value.