消瘀止痛药水结合夹板外固定对桡骨远端骨折肿痛缓解及血液流变学的影响

Effect of Relieving Blood Stasis and Pain Potion Combined with Splint on Relieving Pain and Hemorheology of Distal Radius Fracture

目的观察消瘀止痛药水结合夹板外固定缓解桡骨远端骨折患者肿痛效果及对患者血液流变学的影响。方法选取2019年1月—2020年12月于医院治疗的桡骨远端骨折患者,按照随机数字表法分为对照组和观察组,每组50例。对照组患者给予手法复位加夹班外固定治疗。观察组在对照组基础上,在手法复位后采用消瘀止痛药水包敷患处,再行夹板外固定。然后对两组患者进行3个月的病情随访。比较两组患者疗效。比较两组患者复位前及复位后1天、复位后1周及复位后2周的VAS评分及肿胀程度评分。比较两组患者治疗前及治疗后应激指标[丙二醛(MDA)水平,黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)水平]。比较两组患者术后3天[纤维蛋白原(FIB)、全血低切黏度(LBV)、全血高切黏度(HBV)及血浆黏度(PV)]。比较两组患者住院时间及骨折愈合时间。结果观察组及对照组有效率分别为96.00%和82.00%(χ^(2)=5010,P=0.025)。复位前,两组患者VAS评分及肿胀程度评分均无差异(P>0.05)。观察组复位后1天、复位后1周、复位后2周的VAS评分均低于对照组(t=9.353,P=0.000;t=18.499,P=0.000;t=23.195,P=0.000)。观察组复位后1天、复位后1周、复位后2周的肿胀程度评分均低于对照组(t=4.853,P=0.000;t=13.368,P=0.000;t=5.437,P=0.000)。治疗前,两组患者MDA及SOD无差异(P>0.05)。治疗后,观察组MDA均低于对照组(t=3.644,P=0.000),SOD均高于对照组(t=2.447,P=0.000)。观察组FIB、LBV、HBV、PV均低于对照组(t=5.815,P=0.000;t=4.081,P=0.000;t=2.092,P=0.000;t=4.208,P=0.000)。观察组住院时间及愈合时间均短于对照组(t=6.740,P=P=0.000;t=5.567,P=0.000)。结论消瘀止痛药水结合夹板外固定治疗桡骨远端骨折可以有效缓解患者肿痛,降低患者应激反应,改善患者血液黏滞度,缩短患者住院时间及骨折愈合时间。

Objective To observe the effect of relieving blood stasis and pain potion combined with splint external fixation on pain relief and hemorheology in patients with distal radius fracture.Methods The patients with distal radius fracture treated in the hospital from January 2019 to December 2020 were divided into control group and observation group according to random digital table method,50 cases in each group.The control group was treated with manual reduction and external fixation.On the basis of the control group,the observation group was treated with relieving blood stasis and pain potion and external application after fixation.Then the two groups were followed up for 3 months.The curative effect of the two groups was compared.The visual analog scale(VAS)scores and swelling scores were compared between the two groups before and 1 day after reduction,1 and 2 weeks after reduction.The levels of malondialdehyde(MDA)and xanthine oxidase assay for the determination of superoxide dismutase(SOD)were compared before and after treatment.The levels of fibrinogen(FIB),whole blood low shear viscosity(LBV),whole blood high shear viscosity(HBV)and plasma viscosity(PV)of the two groups were compared 3 days after operation.The hospitalization time and fracture healing time of the two groups were compared.Results The effective rates of the observation group and the control group were 96.00%and 82.00%,respectively(χ^(2)=5010,P=0.025).There was no difference in VAS score or swelling score between the two groups before reduction(P>0.05).The VAS scores in the observation group at 1 day after reduction,1 and 2 weeks after reduction were lower than those of the control group(t=9.353,P=0.000;t=18.499,P=0.000;t=23.195,P=0.000).The swelling scores of the observation group at 1 day after reduction,1 and 2 weeks after reduction were lower than those of the control group(t=4.853,P=0.000;t=13.368,P=0.000;t=5.437,P=0.000).There was no difference in MDA or SOD between the two groups before treatment(P>0.05).The MDA of the observation group was lower than that of the control group(t=3.644,P=0.000)and the SOD was higher than that of the control group(t=2.447,P=0.000).The levels of fibrinogen(FIB),whole blood low shear viscosity(LBV),whole blood high shear viscosity(HBV)and plasma viscosity(PV)of the observation group were lower than those of the control group(t=5.815,P=0.000;t=4.081,P=0.000;t=2.092,0.000;t=4.208,P=0.000).The hospitalization time and healing time of the observation group were shorter than those of the control group(t=6.740,P=0.000;t=5.567,P=0.000).Conclusion The treatment of distal radius fracture with relieving blood stasis and pain potion and splint can effectively relieve the pain,reduce the stress response,improve the blood viscosity and shorten the hospitalization time and fracture healing time.