经皮微创钢板内固定术联合高压氧对胫骨平台骨折病人的疗效

Efficacy of percutaneous minimally invasive plate internal fixation combined with hyperbaric oxygen in patients with tibial plateau fractures

目的 分析经皮微创钢板内固定术(MIPPO)联合高压氧对胫骨平台骨折病人疗效与血清疼痛指标影响。方法 选取2014年1月至2016年6月于河北省深州市医院行手术治疗的胫骨平台骨折病人84例,随机数字表法将病人分为对照组行切开复位内固定术,观察组关节镜下MIPPO术联合高氧压治疗,观察病人手术状况、骨折复位、膝关节功能恢复,及术后并发症情况。结果 观察组病人切口长度为(4.38±1.50)cm,低于对照组的(9.14±1.67)cm,观察组病人骨折愈合时间为(13.70±2.31)周,低于对照组的(15.16±2.14)周,观察组病人住院时间为(10.48±2.40)d,低于对照组的(13.10±2.21)d,观察组病人完全负重时间为(12.25±3.21)周,低于对照组的(14.01±3.14)周,均差异有统计学意义(P<0.05)。观察组病人术后6个月血清FGF-2、IFG-1水平为(26.97±4.42)ng/L、(161.72±20.19)μg/L,高于对照组的(24.86±4.16)ng/L、(144.36±16.80)μg/L,均差异有统计学意义(P<0.05)。并发症总发生率观察组为4.76%,对照组为19.05%(P<0.05)。结论 MIPPO联合高压氧可有效降低胫骨平台骨折病人疼痛应激指标,提高术后骨折复位和膝关节功能恢复程度。

Objective To analyze the effect of percutaneous minimally invasive plate internal fixation (MIPPO) combined with hyperbaric oxygen on tibial plateau fractures and serum pain indexes.Methods A total of 84 patients with tibial plateau fractures who underwent surgical treatment in Shenzhou Hospital of Hebei Province from January 2014 to June 2016 were selected.The patients were randomly divided into a control group,which underwent open reduction and internal fixation,and an observation group,which underwent arthroscopic MIPPO combined with hyperoxia therapy.The operation status,fracture reduction,knee joint function recovery,and postoperative complications were observed.Results The length of the incision in the observation group was (4.38±1.50) cm,which was lower than that in the control group (9.14±1.67) cm.The fracture healing time of the patients in the observation group was (13.70±2.31)weeks,which was lower than that in the control group (15.16±2.14) weeks.The hospitalization time of patients in the observation group was (10.48±2.40) days,which was lower than that of the control group (13.10±2.21) days,and the time of complete weight-bearing of the patients in the observation group was (12.25±3.21) weeks,which was lower than that of the control group (14.01±3.14) weeks,and the difference was significant (P<0.05).The serum levels of FGF-2 and IFG-1 in the observation group 6 months after the operation were (26.97±4.42) ng/L and (161.72±20.19)μg/L,respectively,which were higher than those in the control group (24.86±4.16) ng/L and (144.36±16.80)g/L,and the difference was significant (P<0.05).The total incidence of complications in the observation group was4.76%,while that in the control group was 19.05%(P<0.05).Conclusion MIPPO combined with hyperbaric oxygen can effectively reduce pain and stress indicators in patients with tibial plateau fractures and improve postoperative fracture reduction and knee joint function recovery.