醋氯芬酸联合康复治疗胫骨骨折的疗效及对患者肢体功能和VAS评分的影响

Aceclofenac Combined Rehabilitation Therapy in Patients with Tibial Fracture Postoperative Observation and Effects on Limb Function and VAS Score

目的:观察醋氯芬酸联合康复治疗在胫骨骨折术后患者中的疗效以及其对肢体功能、视觉模拟疼痛(VAS)评分的影响。方法:选择2018年5月—2019年9月我院收治的胫骨骨折术后患者78例,随机分为对照组(39例)和观察组(39例)。对照组术后给予康复治疗,观察组在对照组基础上联合醋氯芬酸干预,8周后对其临床效果进行评估,比较两组患者的肢体功能、VAS评分、骨代谢指标水平、并发症发生率及预后。结果:观察组治疗后8周膝关节Harris(78.94±6.73)分、髋关节HSS评分(90.52±8.71)分、BI评分(81.74±8.43)分及ROM(95.33±7.59)均高于对照组[膝关节Harris(64.34±5.97)分、髋关节HSS评分(79.67±7.92)分、BI评分(73.23±8.09)分及ROM(75.45±6.51)°],差异有统计学意义(P<0.05);观察组治疗后1、4、6、8周的VAS评分分别为(5.41±0.34)分、(4.12±0.28)分、(3.55±0.24)分及(2.69±0.21)分,均低于对照组的(6.89±0.41)分、(5.75±0.34)分、(5.12±0.33)分及(4.12±0.26)分(P<0.05);治疗后8周,观察组骨碱性磷酸酶(BALP)水平(5.84±0.61)%、Ⅰ型前胶原羧基端肽(PICP)水平(154.31±12.49)μg/L及骨钙素(BGP)水平(4.38±0.61)μg/L均高于对照组骨代谢BALP水平(4.62±0.46)%、PICP水平(121.59±9.61)μg/L及BGP水平(3.23±0.56)μg/L(P<0.05);Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平(0.32±0.09)μg/L低于对照组(0.48±0.10)μg/L(P<0.05);观察组治疗过程中感染、膝关节僵硬、骨折不愈及血栓发生率为5.13%,低于对照组的17.95%,差异有统计学意义(P<0.05)。结论:醋氯芬酸联合康复治疗胫骨骨折能改善患者肢体功能,减轻患者疼痛,改善骨代谢指标水平,降低术后并发症发生率,值得临床推广应用。

Objective To investigate the effect of aceclofenac combined with rehabilitation therapy in patients with tibial fractures and its effect on limb function and visual analog scale(VAS)score.Methods 78 patients with tibial fractures from May 2018 to September 2019 were selected as subjects and were randomly divided into control group(n=39 cases)and observation group(n=39 cases).The control group was given rehabilitation treatment after operation.The observation group was combined with aceclofenac intervention on the basis of the control group.After 8 weeks,the limb function,VAS score,bone metabolism index level,complication rate and prognosis of the patients were evaluated.Results The knee group Harris(78.94±6.73)score,hip HSS score(90.52±8.71)score,BI score(81.74±8.43)score and ROM(95.33±7.59)were higher than those of the control group,which 8 weeks after treatment in the observation group Knee Harris(64.34±5.97)points,hip HSS score(79.67±7.92)points,BI score(73.23±8.09)points and ROM(75.45±6.51)(P<0.05).The VAS scores after treatment in the observation group that 1 week(5.41±0.34),4 weeks(4.12±0.28),6 weeks(3.55±0.24)and 8 weeks(2.69±0.21)are all lower than those of the control group,which 1 week(6.89±0.41),4 weeks(5.75±0.34),6 weeks(5.12±0.33)and 8 weeks(4.12±0.26)(P<0.05).Bone metabolism level(5.84±0.61)%,PICP level of bone metabolism in the observation group 8 weeks after treatment(154.31±12.49)μg/L and BGP level(4.38±0.61)μg/L were higher than those of the control group,which bone metabolic BALP level(4.62±0.46)%,PICP level(121.59±9.61)μg/L and BGP level(3.23±0.56)μg/L(P<0.05).β-CTX level(0.32±0.09)μg/L was lower than that of the control group(0.48±0.10)μg/L(P<0.05)8 weeks after treatment.During the observation group,treatment infection,the rate of knee stiffness,fracture healing,thrombosis and incidence(5.13%)were lower than those of the control group(17.95%)(P<0.05).Conclusion Aceclofenac combined with rehabilitation therapy in patients with tibial fractures can improve the patient’s limb function,reduce the patient’s pain,improve the level of bone metabolism index and reduce the incidence of postoperative complications,which is worthy of popularization and application.