中药熏洗联合掌侧锁定钢板固定在桡骨远端粉碎性骨折患者中的应用

Application Effect of Fumigation and Washing with Chinese Medicinals Combined with Volar Locking Plate Fixation on Comminuted Fracture of Distal Radius

目的:观察中药熏洗联合掌侧锁定钢板固定在桡骨远端粉碎性骨折患者中的应用效果。方法:将70例桡骨远端粉碎性骨折患者采用随机数字表法分为对照组和观察组,每组各35例。所有患者择期进行掌侧锁定钢板固定,手术后,对照组给予抗生素治疗3~5 d,进行常规对症治疗,并指导患者进行功能锻炼。观察组在对照组治疗的基础上给予中药熏洗治疗。观察两组患者手术前后疼痛视觉模拟评分、Gartland-Werley腕关节功能评分、骨钙素(bone gla protein,BGP)、骨源性碱性磷酸酶(bone alkaline phosphatase,BALP)、血浆诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)、内皮型一氧化氮合酶(endothelial nitric oxide synthase eNOS)、白细胞介素(interleukin,IL)-1和IL-6水平,并比较两组并发症发生情况。结果:两组术后6周、12周VAS均低于治疗前,且观察组治疗后6周、12周VAS评分低于对照组,差异有统计学意义(P<0.05);观察组腕关节功能评分优良率为80.00%,对照组腕关节功能评分优良率为57.14%,观察组高于对照组,差异有统计学意义(P<0.05);两组治疗后BGP、BALP、iNOS、eNOS、IL-1、IL-6水平均优于治疗前,且观察组治疗后BGP、BALP、iNOS、eNOS、IL-1、IL-6水平均优于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为11.42%,对照组并发症发生率为14.29%,两组并发症发生率比较差异无统计学意义(P>0.05)。结论:中药熏洗治疗联合掌侧锁定钢板固定治疗桡骨远端粉碎性骨折,能够显著改善患者腕关节功能,减轻患者疼痛,且安全性良好。

Objective:To observe the application effect of fumigation and washing with Chinese medicinals combined with volar loc-king plate fixation on comminuted fracture of distal radius.Methods:A total of 70 patients with comminuted fracture of distal radius were randomly divided into the control group and the observation group,with 35 cases in each group.All patients were fixed with volar locking plate on the selected date.After the operation,the control group was treated with antibiotics for 3 to 5 days,received routine symptomatic treatment,and guided functional exercise.The observation group was treated with fumigation and washing with Chinese medicinals on the basis of the control group.The pain visual analogue score,Gartland-Werley wrist function score,bone gla protein(BGP),bone alkaline phosphatase(BALP),plasma inducible nitric oxide synthase(iNOS),endothelial nitric oxide synthase(eNOS)and The levels of interleukin(IL)-1 and IL-6,and the complications of the two groups were compared.Results:The VAS of the two groups at 6th and 12th week after operation was lower than that before operation respectively,and the VAS score of the observation group at 6th and 12th week after operation was lower than that of the control group,and all the differences were statistically significant(P<0.05).The excellent rate of wrist function score in the observation group was 80.00%,which was significantly higher than that in the control group:57.14%,and the difference was statistically significant(P<0.05).After treatment,BGP,BALP,iNOS,eNOS,IL-1 and IL-6 in the two groups were better than those before treatment,and the above inde-xes in the observation group were better than those in the control group,and all the differences were statistically significant(P<0.05).The incidence of complications was 11.42%in the observation group and 14.29%in the control group.There was no sig-nificant difference between the two groups(P>0.05).Conclusion:Fumigation and washing with Chinese medicinals combined with volar locking plate fixation in the treatment of comminuted fractures of the distal radius can significantly improve the wrist function,reduce pain,and have good safety.