逐瘀通络法对桡骨远端骨折患者锁定加压钢板内固定术后早期康复的影响

Intervention Effect of Removing Blood Stasis and Dredging Collaterals Method on Early Recovery after Locking Compression Plate Internal Fixation

目的:探讨逐瘀通络法对桡骨远端骨折手法复位失败患者锁定加压钢板(locking compression plate,LCP)内固定术后早期炎症状态、骨折愈合及关节功能恢复的干预作用。方法:选取2019年4月—2021年4月我院收治的68例桡骨远端骨折术后患者作为研究对象,随机数字法分为LCP组及联合组,每组各34例,LCP组患者采用锁定加压钢板治疗,联合组在LCP手术后采用逐瘀通络法治疗。结果:联合组患者肿胀消退时间、疼痛消退时间、瘀斑消失时间及骨折影像愈合时间均低于LCP组(P<0.05);治疗后,与LCP组相比,联合组患者血浆中炎症因子C反应蛋白(c-reactive protein,CRP)、白细胞介素(interleukin,IL)-6、IL-1β、丙二醛(malondialdehyde,MDA)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP)降低,超氧化物歧化酶(superoxide dismutase,SOD)及谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)升高(P<0.05);与LCP组相比,联合组患者背伸、掌屈、桡偏及尺偏活动度均升高(P<0.05);LCP组患者不良反应发生率高于联合组(P<0.05)。结论:逐瘀通络法能够通过抑制桡骨远端骨折患者术后炎症指标及氧化应激水平,发挥促进骨折愈合改善腕关节功能的作用,值得临床推广应用。

Objective To investigate the intervention effect of stasis removing and collasing-removing method on early inflammatory state,fracture healing and joint function recovery after locking compression plate(LCP)internal fixation in patients with failed manual reduction of distal radius fracture.Methods A total of 68 postoperative patients with distal radius fractures admitted to our hospital from April 2019 to April 2021 were selected as the research objects,and they were divided into LCP group and combined group by random number method,with 34 cases in both.Patients in the LCP group were treated with locking compression plate,and patients in the combined group were treated with stasis removing and collaterals removing method after LCP surgery.Results The swelling resolution time,pain resolution time,petechiae disappearance time and fracture image healing time in combined group were lower than those in LCP group(P<0.05).After treatment,compared with the LCP group,Plasma levels of the inflammatory factor C-reactive protein(CRP)interleukin(IL)-6,IL-1β,malondialdehyde(MDA),and advanced oxidation of protein protein products(AOPP)in the combined group decreased,superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)increased(P<0.05).Compared with LCP group,dorsiflexion,metacarpal flexion,radial deviation and ulnar deviation were increased in combined group(P<0.05).The adverse reactions in LCP group were higher than those in combined group(P<0.05).Conclusion The method can promote fracture healing and improve wrist joint function by inhibiting postoperative inflammatory indexes and oxidative stress levels of patients with distal radius fracture,which is worthy of application.