应用损伤控制骨科治疗复合伤中的胫骨上段粉碎骨折

Application of Damage Control Orthopaedics in Treatment of Comminuted Fracture of Upper Tibia in Combined Injuries

目的分析应用损伤控制骨科治疗复合伤中的胫骨上段粉碎骨折的效果。方法以2016年6月-2018年6月间入该院治疗的80例胫骨上段粉碎骨折患者为研究主体。分成A组和B组,均是40例。A组应用损伤控制骨科治疗,B组给予常规治疗。结果 A组的有无跛行评分为(3.54±0.78)分,B组为(2.12±0.62)分(t=9.013,P=0.000);A组的有无绞痛评分为(11.68±3.05)分,B组为(8.15±3.01)分(t=5.210,P=0.000);A组的是否借助拐杖评分为(4.98±0.75)分,B组为(4.01±0.66)分(t=6.141,P=0.000);A组的有无疼痛评分为(19.87±2.65)分,B组为(12.37±2.48)分(t=13.069,P=0.000);A组的关节稳定性评分为(24.13±2.11)分,B组为(19.67±2.07)分(t=9.543,P=0.000);A组的上下楼梯是否困难评分为(7.78±1.65)分,B组为(6.91±1.52)分(t=2.453,P=0.016);A组的有无肿胀评分为(7.06±2.14)分,B组为(5.37±2.11)分(t=3.557,P=0.001);A组的下蹲是否困难评分为(4.25±0.77)分,B组为(3.76±0.69)分(t=2.997,P=0.004)。A组的治疗优良率为95.0%,B组为67.5%(χ2=4.588,P=0.032)。A组的PF(生理机能)评分为(88.24±2.64)分,B组为(80.19±2.15)分(t=14.954,P=0.000);A组的BP(躯体疼痛)评分为(90.34±2.95)分,B组为(82.67±2.55)分(t=12.440,P=0.000);A组的RP(生理职能)评分为(91.38±2.85)分,B组为(84.37±2.42)分(t=11.858,P=0.000);A组的VT(精力)评分为(88.67±3.41)分,B组为(81.65±3.52)分(t=9.059,P=0.000);A组的MH(精神健康)评分为(92.37±2.85)分,B组为(87.34±2.48)分(t=8.421,P=0.000);A组的SF(社会功能)评分为(89.33±2.41)分,B组为(83.15±2.17)分(t=12.052,P=0.000);A组的RE(情感职能)评分为(93.54±2.10)分,B组为(85.69±2.17)分(t=16.441,P=0.000);A组的GH(一般健康状况)评分为(85.67±1.52)分,B组为(80.33±1.49)分(t=15.867,P=0.000)。结论为该类骨折患者行损伤控制骨科治疗可改善其膝关节功能和生活质量,具有较佳的治疗效果。

Objective To analyze the effect of injury control orthopaedics in the treatment of comminuted fracture of upper tibia in compound injury. Methods A total of 80 cases of upper tibial comminuted fractures admitted to our hospital from June 2016 to June 2018 were studied. They were divided into group A and group B, with 40 cases in each group. Group A received orthopaedic treatment of injury control, while group B received routine treatment. Results The limp score of group A was(3.54±0.78)points, and was(2.12 ±0.62)points of group B(t =9.013, P =0.000). The colic score was(11.68 ±3.05)points in group A, and was(8.15±3.01)points in group B(t=5.210, P=0.000). The crutches score was(4.98±0.75)points in group A, and was(4.01±0.66)points in group B(t=6.141, P=0.000). The pain score in group A was(19.87±2.65)points, and was(12.37±2.48)points in group B(t=13.069, P=0.000). The joint stability score in group A was(24.13 ±2.11)points, and was(19.67 ±2.07)points in group B(t =9.543, P =0.000). The stairs difficulty score in group A was(7.78±1.65)points, and was(6.91±1.52)points in group B(t=2.453, P=0.016). The swelling score in group A was(7.06±2.14)points, and was(5.37±2.11)points in group B(t=3.557, P=0.001). Squatting difficulty score in group A was(4.25±0.77)points, and was(3.76±0.69)points in group B(t=2.997, P=0.004). The excellent and good rate was 95.0% in group A and 67.5% in group B(χ~2=4.588, P=0.032). The PF(physiological function) score in group A was(88.24±2.64)points,and was(80.19±2.15)points in group B(t=14.954, P=0.000). The BP(somatic pain) score in group A was(90.34±2.95)points, and was(82.67±2.55)points in group B(t=12.440, P=0.000). The RP score in group A was(91.38±2.85)points,and was(84.37±2.42)points in group B(t=11.858, P=0.000). The VT score of group A was(88.67±3.41)points, and that of group B was(81.65±3.52)points(t=9.059, P=0.000). MH(mental health) score of group A was(93.37 ±2.85)points,and was(87.34±2.48)points of group B(t=8.421, P=0.000). SF(social function) score was(89.33±2.41)points in group A, and was(83.15±2.17)points in group B(t=12.052, P=0.000). RE(emotional function) score of group A was(93.54±2.10)points score, and was(85.69±2.17)points of group B(t=16.441, P=0.000). GH(General health) score was(85.67±1.52)points in group A, and was(80.33 ±1.49)points in group B(t=15.867, P=0.000). Conclusion Injury control orthopaedic treatment can improve the knee function and quality of life of patients with this kind of fracture, which has a better therapeutic effect.