疲劳和营养不良对腕舟状骨骨折不愈合术后恢复的影响

Effects of fatigue and malnutrition on postoperative recovery of nonunion of carpal scaphoid fracture

目的 探讨疲劳和营养不良对腕舟状骨骨折不愈合患者术后恢复的影响。方法 选择我院收治的150例行手术治疗的腕舟状骨骨折不愈合患者为研究对象。采用疲劳严重度量表(FSS)、简易营养评估法(MNA-SF)评估患者术后疲劳程度和营养状态;记录患者术后住院时间及术后切口感染、切口裂开、切口愈合延迟、握力、腕关节功能(改良Mayo腕关节评分)情况。结果 术后疲劳59例(39.33%),营养不良45例(30.00%)。疲劳组患者术后住院时间、骨折愈合时间长于无疲劳组(P<0.05),改良Mayo腕关节评分、握力低于无疲劳组(P<0.05)。营养不良组患者术后住院时间、骨折愈合时间长于营养正常组(P<0.05),改良Mayo腕关节评分、握力低于营养正常组(P<0.05),切口感染、切口愈合延迟发生率高于营养正常组(P<0.05)。FSS评分与MNA-SF评分呈负相关(r=-0.422,P<0.05)。结论 术后疲劳和营养不良可能会延长患者术后住院时间和骨折愈合时间,影响腕关节功能恢复,增加并发症发生风险。

Objective To investigate the effects of fatigue and malnutrition on the postoperative recovery of patients with nonunion of carpal scaphoid fracture.Methods A total of 150 patients with nonunion of carpal scaphoid fracture who underwent surgical treatment in our hospital were selected.Fatigue severity scale(FSS)and mini nutritional assessment short-form(MNA-SF)were used to evaluate the postoperative fatigue and nutritional status of the patients.Postoperative hospital stay,postoperative incision infection,incision dehiscence,delayed incision healing,grip strength,and wrist function(modified Mayo wrist score)of patients were recorded.Results There were 59 cases of fatigue(39.33%),45 cases of malnutrition(30.00%).The postoperative hospital stay and fracture healing time of patients in fatigue group were longer than those in the non-fatigue group(P<0.05),and the modified Mayo wrist score and grip strength of patients were lower than those in the non-fatigue group(P<0.05).The postoperative hospital stay and fracture healing time of patients in malnutrition group were longer than those in normal nutrition group(P<0.05),the modified Mayo wrist score and grip strength of patients were lower than those in normal nutrition group(P<0.05),and the incidence of incision infection and delayed incision healing was higher than that of normal nutrition group(P<0.05).There was a negative correlation between FSS score and MNA-SF score(r=-0.422,P<0.05).Conclusion Postoperative fatigue and malnutrition may prolong postoperative hospital stay and fracture healing time,affect the recovery of wrist function,and increase the risk of complications.