四肢骨折术中骨折端血肿回植对患者骨折愈合及骨生化指标的影响

Effect of hematoma replantation in fracture end on fracture healing and bone biochemical indexes in patients with limb fracture operation

目的探讨四肢骨折术中骨折端血肿回植对患者骨折愈合及骨生化指标的影响。方法选取2017年6月至2019年6月该院收治的四肢骨折患者120例作为研究对象,根据患者不同治疗方法将其分为对照组(60例,术中未接受血肿回植)和研究组(60例,术中接受血肿回植)。比较两组术后骨折愈合时间及术后1、3及6个月的骨折愈合率,术后1个月骨生化指标(Ⅰ型前胶原羧基端肽、骨钙素、骨碱性磷酸酶)水平。结果研究组骨折愈合时间明显短于对照组[(1.4±0.2)个月vs.(2.5±0.3)个月,P<0.05];两组术后1、6个月愈合率无明显差异(P>0.05),术后3个月研究组骨折愈合率明显高于对照组(95.00%vs.71.67%,P<0.05)。术后1个月研究组血清Ⅰ型前胶原羧基端肽[(168.53±16.27)μg/L]、骨钙素[(12.05±2.94)μg/L]、骨碱性磷酸酶[(248.86±22.25)μg/L]水平明显高于对照组[(154.76±14.38)、(9.04±3.12)、(232.64±20.03)μg/L,P<0.05]。结论四肢骨折术中骨折端血肿回植可提高骨生化指标水平,促进患者术后早期成骨细胞的增殖和分化,缩短患者骨折愈合时间,临床疗效满意。

Objective To investigate the effect of hematoma replantation on fracture healing and bone biochemical indexes in patients with limb fracture operation.Methods A total of 120 cases of limb fracture admitted and treated in this hospital from June 2017 to June 2019 were selected as the research subjects and divided into the control group(60 cases,without receiving intraoperative hematoma replantation)and study group(60 cases,receiving intraoperative hematoma replantation)according to different treatment methods.The postoperative fracture healing time,fracture healing rate in postoperative 1,3,6 months,levels of bone biochemical indicators(typeⅠprocollagen carboxyl terminal peptide,osteocalcin,bone alkalinity phosphatase)in postoperative 1 month were compared between the two groups.Results The fracture healing time of the study group was significantly shorter than that of the control group[(1.4±0.2)months vs.(2.5±0.3)months,P<0.05];there was no significant difference in the healing rate in postoperative 1,6 months between the two groups(P>0.05),and the fracture healing rate in postoperative 3 months in the study group was significantly higher than that of the control group(95.00%vs.71.67%,P<0.05).In postoperative 1 month,the levels of serum typeⅠprocollagen carboxyl terminal peptide(168.53±16.27)μg/L,osteocalcin(12.05±2.94)μg/L,and bone alkaline phosphatase(248.86±22.25)μg/L in the study group were significantly higher than those in the control group[(154.76±14.38)μg/L,(9.04±3.12)μg/L,(232.64±20.03)μg/L,P<0.05].Conclusion The replantation of hematoma in the fracture end during the limb fracture operation can improve the level of bone biochemical indexes,promote the proliferation and differentiation of osteoblasts in the postoperative early stage,shorten the fracture healing time of the patients,and the clinical effect is satisfactory.