经皮微创接骨板内固定术治疗老年四肢骨折的效果观察

Observation on the Effect of Percutaneous Minimally Invasive Bone Plate Internal Fixation in the Treatment of Elderly Limb Fractures

目的分析经皮微创接骨板内固定术(MIPPO)治疗老年四肢骨折的效果。方法选取2018年2月~2019年2月于我院诊治的老年四肢骨折患者60例,采用随机数字表法分为对照组与观察组,每组30例。对照组给予传统钢板内固定术治疗,观察组给予MIPPO治疗,比较两组一般指标(术中出血量、下床活动时间、术后住院时间、骨折愈合时间)、应激反应(SP、PGE_(2)、NPY)、炎性因子水平(CRP、IL-8、TNF-α)和骨折愈合情况。结果观察组术中出血量、下床活动时间、术后住院时间、骨折愈合时间均低于对照组,差异有统计学意义(P<0.05);两组术后SP、PGE_(2)、NPY水平均高于术前,且观察组SP、PGE_(2)、NPY水平低于对照组,差异有统计学意义(P<0.05);两组术后CRP、IL-8、TNF-α水平均高于术前,且观察组CRP、IL-8、TNF-α水平低于对照组,差异有统计学意义(P<0.05);观察组骨折愈合率为90.00%,高于对照组的66.67%,差异有统计学意义(P<0.05)。结论MIPPO治疗老年四肢骨折可减少术中出血量,缩短下床活动时间、术后住院时间、骨折愈合时间,减轻手术应激和炎症反应,提升骨折愈合率。

Objective To analyze the effect of percutaneous minimally invasive bone plate internal fixation(MIPPO)in the treatment of elderly limb fractures.Methods A total of 60 elderly patients with limb fractures diagnosed and treated in our hospital from February 2018 to February 2019 were selected and divided into a control group and an observation group using a random number table method,with 30 cases in each group.The control group was treated with traditional plate internal fixation,and the observation group was treated with MIPPO.The two groups of general indicators(intraoperative blood loss,time to get out of bed,postoperative hospital stay,fracture healing time),stress response(SP,PGE_(2),NPY),inflammatory factor levels(CRP,IL-8,TNF-α)and fracture healing.Results The intraoperative blood loss,time to get out of bed,postoperative hospital stay,and fracture healing time in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05);The levels of SP,PGE_(2) and NPY in the two groups after operation were higher than those before operation.The levels of SP,PGE_(2) and NPY in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05);The levels of CRP,IL-8 and TNF-αin the two groups after operation were higher than those before the operation.The levels of CRP,IL-8 and TNF-αin the observation group were lower than those in the control group,the difference was statistically significant(P<0.05);The fracture healing rate in the observation group was 90.00%,which was higher than the 66.67%in the control group,the difference was statistically significant(P<0.05).Conclusion MIPPO treatment of elderly limb fractures can reduce intraoperative blood loss,shorten the time of getting out of bed,postoperative hospital stay,fracture healing time,relieve surgical stress and inflammation,and improve fracture healing rate.