骨搬移技术治疗胫骨骨缺损及血清炎症因子的变化:X射线影像学评价

Serum levels of inflammatory factors in patients with tibial bone defect treated by Ilizarov bone transport: X-ray assessment

背景:传统清创、植骨治疗胫骨骨缺损的临床疗效是肯定的,但这一方法针对大段骨缺损则具有较显著的局限性。目的:观察骨搬移技术治疗胫骨骨缺损的疗效及对血清炎症因子的影响。方法:选取78例胫骨骨缺损患者,随机分为2组,观察组40例接受Ilizarov骨搬移术,对照组38例接受单臂外固定架术。两组分别于术后6个月通过X射线摄片判断其影像学总有效率,通过paley评价标准判定其临床疗效,并通过门诊随访12个月判断其不良反应发生率。采用ELASA法检测血清C-反应蛋白、肿瘤坏死因子α及核因子κB水平。结果与结论:两组患者经过治疗后6个月影像学疗效相比差异有显著性意义(P <0.05),观察组影像学总有效率及paley评价临床疗效优良率均高于对照组(P <0.05)。治疗后12个月,观察组血清C-反应蛋白、肿瘤坏死因子α、核因子κB水平及不良反应发生率较对照组显著降低(P <0.05)。上述数据说明,Ilizarov骨搬移技术较传统疗法治疗胫骨骨缺损具有较为满意的疗效,且不良反应发生率较低,同时对炎症因子也有一定的抑制作用。

BACKGROUND:Therapeutic effects of traditional debridement and bone graft for tibial defect were obvious,but this method has a certain limitation in large bone defect.OBJECTIVE:To observe the treatment therapy and serum levels of inflammatory factors in patients with tibia bone defect treated by Ilizarov bone transport.METHODS:Seventy-eight patients with tibia bone defect were selected and randomized into observation group(n=40,Ilizarov bone transport)and control group(n=38,unilateral external fixator).The total effective rate of iconography was measured by radiography at postoperative 6 months.The clinical effect was measured by paley evaluation criterion.The incidence of complications was detected by 12-month follow-up.The serum levels of C-reactive protein,tumor necrosis factor-αand nuclear factor-κB were measured by ELISA.RESULTS AND CONCLUSION:The difference was significant in the iconography effect between two groups at 6 months postoperatively(P<0.05),total effective rate of iconography and excellent and good rate in the observation group were significantly higher than those in the control group(P<0.05).At postoperative 12 months,the serum levels of C-reactive protein,tumor necrosis factor-αand nuclear factor-κB as well as incidence of complications in the observation group were significantly lower than those in the control group(P<0.05).To conclude,Ilizarov bone transport is more effective compared with traditional remedies in tibia bone defect,and the incidence of complications is lower.It has a certain inhibitory effect on inflammatory factors.