微创内固定稳定系统治疗股骨远端骨折的效果及其对疼痛度及炎症应激反应的影响

Effect of Less invasive internal fixation stabilization system in the treatment of distal femoral fractures and its influence on pain degree and inflammatory stress response

目的:探究股骨远端骨折患者应用微创内固定稳定系统(less invasive stabilization system,LISS)的手术效果及其对疼痛程度及炎症应激反应的影响。方法:选取我院2020年2月至2022年2月期间收治的股骨远端骨折患者81例,随机分为对照组(40例)与观察组(41例),对照组接受传统股骨髁钢板内固定术治疗,观察组接受LISS内固定治疗,对比两组患者膝关节功能、不同状态下疼痛程度及术后炎症应激反应。结果:观察组美国特种外科医院膝关节(Hospital for Special Surgery,HSS)评分高于对照组,膝骨关节炎的西大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster universities,WOMAC)评分低于对照组(P<0.05);观察组在负重行走、主动活动、静息状态下的视觉模拟评分法(Visual analogue scale,VAS)评分均明显低于对照组(P<0.05);术后24h,两组血清白细胞介素1(Interleukin-1,IL-1)、去甲肾上腺素(Norepinephrine,NE)、肾上腺素(Epinephrine,E)、促肾上腺皮质激素(Adrenocorticotropic hormone,ACTH)较术前均明显升高,且观察组波动幅度低于对照组(P<0.05)。结论:微创LISS系统内固定应用于股骨远端骨折患者,能够更有效降低软组织损伤,恢复膝关节功能,减轻疼痛,减少炎症应激反应。

Objective:To explore the efficacy of the less invasive stabilization system(LISS)in patients with distal femoral fractures and its effect on pain and inflammatory stress response.Methods:A total of 81 patients with distal femoral fracture admitted to our hospital from February 2020 to February 2022 were selected and randomly divided into control group(40 cases)and observation group(41 cases).The control group was received traditional femoral condyle plate internal fixation,while the observation group was received LISS internal fixation.The knee function,pain degree and postoperative inflammatory stress response were compared between the two groups.Results:The Hospital for Special Surgery(HSS)score of the observation group was higher than that of the control group,and the Western Ontario and McMaster universities(WOMAC)scale of knee osteoarthritis of the observation group was lower than that of control group(P<0.05).The Visual analogue scale(VAS)score of the observation group was significantly lower than that of the control group under loading walking,active activity and resting state(P<0.05);24 h after surgery,the levels of serum Interleukin-1(IL-1),Norepinephrine(NE),Epinephrine(E)and Adrenocorticotropic hormone(ACTH)were significantly higher than those before surgery,and the fluctuation ranges in observation group were lower than those in control group(P<0.05).Conclusion:The application of LISS internal fixation in patients with distal femoral fracture can more effectively reduce soft tissue injury,restore knee function,and relieve pain,and reduce inflammatory stress response.