保护锁骨上神经项链切口治疗锁骨骨折的效果分析

Effect Analysis of Protective Supraclavicular Nerve Necklace Incision in Treatment of Clavicular Fracture

目的:探讨锁骨骨折(CF)患者行项链切口治疗中锁骨上神经的保护效果。方法:将我院2020年2月-10月收治的锁骨骨折患者70例随机平分成观察组与对照组,均行项链切口复位内固定术(ORIF)治疗,对照组直接切断锁骨上神经,观察组显露和复位骨折,保护性游离锁骨上神经,观察2组手术疗效、并发症、皮肤麻木面积、神经VAP评分等。结果:观察组治疗效果高于对照组(94.29%vs77.14%),皮肤麻木面积小于对照组[(12.72+2.19)cm^(2)vs(14.37+2.25)cm^(2)],神经VAS评分[(2.41+0.60)vs(3.33+0.58)],疼.痛评分[(6.44+0.14)vs(7.39+0.27)]、骨折愈合时间[(12.64+2.57)周vs(14.85+3.92)周]与并发症率(8.57%vs28.57%),低于对照组(P均<0.05)。结论:针对锁骨骨折患者,项链切口复位术中保护锁骨上神经,可减少皮肤麻木面积,促进关节功能恢复,减轻疼痛,减少并发症,改善预后,操作简单,固定效果好,疗效安全可靠,值得临床推广。

Objective:To investigate the protective effect of supraclavicular nerve in patients with clavicular fracture(CF)treated with necklace incision.Methods:70 patients with clavicular fracture in our hospital were randomly divided into observation group and control group,necklace incision reduction and internal fixation(ORIF),the control group cut the supraclavicular nerve directly,the observation group exposed and reduced the fracture,protective free supraclavicular nerve,the surgical efficacy,complications,skin numb area and nerve VAP score were observed.Results:The therapeutic effect of observation group was higher than control group(94.29%vs77.14%),the skin numb area was less than that of the control group[(12.72±2.19)vs(14.37±2.25)]cm2,neural VAS score[(2.41±0.60)vs(3.33±0.58)],pain score[(6.44±0.14)vs(7.39±0.27)],fracture healing time[(12.64±2.57)vs(14.85±3.92)](week)and complication rate(8.57%vs28.57%)were lower than those of control group(P<0.05).Conclusion:For patients with clavicular fracture,to protect the supraclavicular nerve during necklace incision reduction,can reduce the area of skin numbness,promote joint function recovery,to relieve pain,reduce complications,improved prognosis,simple to operate,good fixation effect,the efficacy is safe and reliable,worthy of clinical promotion.