股骨颈骨折患者术后延迟愈合与微循环因子相关性研究

Study on the Correlation between Delayed Healing and Microcirculation Indexes after Femoral Neck Fracture Surgery

目的:研究股骨颈骨折术后延迟愈合与微循环因子的相关性,以期为促进骨折患者术后早期愈合提供可靠方向。方法:选取2019—2022年在复旦大学附属闵行医院接受内固定手术治疗的股骨颈骨折患者,根据患者术后愈合情况,将其分为正常愈合组(n=87)和延迟愈合组(n=33)。术后6个月对所有患者微循环指标进行检测,对比不同愈合情况患者的微循环因子水平,并分析微循环因子对股骨颈骨折术后延迟愈合的影响。结果:正常愈合组血浆黏度、全血低切黏度、红细胞聚集指数及甲襞微循环形态、流态及襻周积分均低于延迟愈合组,差异有统计学意义(t值分别为9.301、6.368、12.805、11.616、18.788和17.980,P值均<0.05)。正常愈合组血清内皮素(ET)和血清C反应蛋白(CRP)水平低于延迟愈合组,差异有统计学意义(t值分别为6.784和6.410,P值均<0.05)。线性回归分析结果显示,全血低切黏度、血浆黏度、红细胞聚集指数、甲襞微循环形态、流态、襻周积分及ET、CRP是股骨颈骨折患者术后延迟愈合的影响因素。结论:微循环状态及微循环指标ET、CRP水平均在股骨颈骨折术后延迟愈合患者中呈高表达,是患者术后延迟愈合的影响因素。

OBJECTIVE To study the correlation between delayed healing and microcirculation indexes after femoral neck frac⁃ture operation.METHODS A total of 120 patients with femoral neck fracture who underwent surgical treatment in our hospital from December 2019 to December 2022 were selected.According to their postoperative healing,they were divided into normal healing group and delayed healing group.Six months after operation,plasma viscosity,the whole blood low shear viscosity,erythrocyte aggre⁃gation index and nailfold microcirculation index were detected in all patients.The levels of microcirculation indexes in patients with different healing conditions were compared.The regression equation was made by general linear regression analysis,and the influ⁃ence of microcirculation indexes on delayed healing of femoral neck fracture after operation was analyzed.RESULTS The whole blood low shear viscosity,plasma viscosity,erythrocyte aggregation index,nailfold microcirculation morphology,flow pattern and loop cir⁃cumference integral in normal healing group were lower than those in delayed healing group(t=9.301,6.368,12.805,11.616,18.788,17.980,P<0.05).The levels of ET and CRP in normal healing group were lower than those in delayed healing group(t=6.784,6.410,P<0.05).Whole blood low shear viscosity,plasma viscosity,erythrocyte aggregation index,nailfold microcirculation morpholo⁃gy,flow pattern,loop integral,ET and CRP were all influencing factors for delayed healing of patients with femoral neck fracture af⁃ter operation.CONCLUSION Microcirculatory status and microcirculation indexes such as ET and CRP are highly expressed in pa⁃tients with delayed healing after femoral neck fracture surgery,which are the influencing factors of delayed healing after surgery.