外固定支架固定对骨盆骨折患者应激因子、炎性因子水平的影响

Effects of external fixation bracket fixation on stress factor and inflammatory cytokines in patients with traumatic pelvic fractures

目的分析外固定支架联合手术对骨盆骨折患者应激因子、炎性因子水平的影响。方法2015年8月—2018年9月南部战区海军第一医院脊柱关节科收治骨盆骨折患者85例,依据随机数字表法分为对照组(n=42)与研究组(n=43),对照组行抗休克裤或骨盆带固定等常规治疗,研究组行外固定支架固定治疗。观察两组术中出血量、手术时间、骨折愈合时间等临床指标,术前术后血清白介素-10(IL-10)、白介素-13(IL-13)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)等炎性因子水平,血清促甲状腺激素(TSH)、皮质醇(Cor)、肾上腺素(E)等应激因子水平,以及患者恢复情况。结果研究组术中出血量、骨折愈合时间均少于对照组[(150.37±16.24)mL vs.(518.69±53.28)mL,(7.13±1.25)周vs.(9.68±1.02)周],差异有统计学意义(P<0.05)。术后7d,研究组IL-10、IL-13水平均低于对照组[(15.47±1.68)ng/L vs.(18.38±1.97)ng/L;(10.29±1.23)pg/mL vs.(13.03±1.44)pg/mL],TNF-α、IL-1β水平均高于对照组[(5.47±0.53)ng/L vs.(3.34±0.35)ng/L;(4.65±0.47)pg/mL vs.(3.65±0.38)pg/mL],差异有统计学意义(P<0.05)。术后7d研究组Cor、E水平均低于对照组[(157.52±16.83)ng/mL vs.(213.52±22.51)ng/mL;(98.68±10.57)ng/mL vs.(132.86±14.19)ng/mL],TSH水平均高于对照组[(3.08±0.31)mU/L vs.(1.65±0.18)mU/L],差异有统计学意义(P<0.05)。研究组总有效率(93.02%)高于对照组(71.43%),差异有统计学意义(P<0.05)。结论采用外固定支架固定治疗骨盆骨折患者,患者恢复效果良好,且应激因子、炎性因子水平明显改善。

Objective To analyze the external fixation bracket fixation on stress factor and inflammatory cytokines in patients with traumatic pelvic fractures(TPF).Methods Eighty-five patients with TPF admitted to our hospital from Aug.2015 to Sep.2018 were selected and divided into control group(n=42)and research group(n=43)according to random number table method.The control group received conventional treatment and the research group received external fixation bracket fixation.Clinical indexes such as intraoperative blood loss,operation time and fracture healing time were observed in the two groups.Before and after the operation,serum levels of inflammatory factors such as interleukin-10(IL-10),interleukin-13(IL-13),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and stress factors such as serum thyroid stimulating hormone(TSH),cortisol(Cor),epinephrine(E)and recovery condition were observed.Results The bleeding volume,operation time and fracture healing time in the research group were all less than those in the control group[(518.69±53.28)mL vs.(150.37±16.24)mL;(9.68±1.02)weeks vs.(7.13±1.25)weeks](P<0.05).After operation,the levels of IL-10 and IL-13 in the research group were lower than those in the control group[(15.47±1.68)ng/L vs.(18.38±1.97)ng/L;(10.29±1.23)pg/mL vs.(13.03±1.44)pg/mL],and the levels of TNF-αand IL-1βwere higher than those in the control group[(5.47±0.53)ng/L vs.(3.34±0.35)ng/L;(4.65±0.47)pg/mL vs.(3.65±0.38)pg/mL](P<0.05).The levels of Cor and E in the research group were lower than those in the control group[(157.52±16.83)ng/mL vs.(213.52±22.51)ng/mL;(98.68±10.57)ng/mL vs.(132.86±14.19)ng/mL],and TSH levels were higher than those in the control group[(3.08±0.31)mU/L vs.(1.65±0.18)mU/L](P<0.05).The total effective rate in the research group(93.02%)was higher than that in the control group(71.43%,P<0.05).Conclusion The recovery effect of TPF patients treated by external fixator combined with surgery is good,and the levels of stress factors and inflammatory factors are significantly improved.