MIPO在对肱骨骨干骨折的上肢功能影响及安全性分析

Effect of MIPO on Upper Limb Function and Safety of Humeral Shaft Fracture

目的:观察微创经皮钢板内固定术(MIPO)对肱骨骨干骨折患者上肢功能的影响及手术安全性分析。方法:选取2020年1月—2022年2月通许县中医院收治的123例肱骨骨干骨折患者作为研究对象,采用抽签法将其为对照组(61例)和MIPO组(62例)。对照组患者采用常规治疗,MIPO组应用MIPO治疗,比较两组患者围手术期临床指标及治疗前后的肩关节活动度;术后对所有患者开展为期6个月的短期随访,比较两组患者术后1、3、6个月时的肩关节功能恢复情况及随访期间的并发症发生情况。结果:MIPO组患者的术中出血量、术后住院时间、视觉模拟疼痛(VAS)评分均低于对照组,差异有统计学意义(t=2.742、2.817、3.078,P<0.05);治疗后,MIPO组患者的肩关节背伸、内收、上举活动度均大于对照组,差异有统计学意义(t=3.295、2.241、2.774,P<0.05);MIPO组患者术后1、3、6个月时的Constant-Murley肩关节功能评分(CMS)均高于对照组,差异有统计学意义(t=3.117、2.995、2.535,P<0.05);MIPO组患者术后1、3、6个月时的肩关节功能评分系统(UCLA)评分均高于对照组,差异有统计学意义(t=2.362、3.192、2.985,P<0.05);MIPO组患者随访期间的并发症发生率(4.84%)低于对照组(14.75%),差异有统计学意义(χ^(2)=5.558,P<0.05)。结论:与常规手术相比,应用MIPO治疗肱骨骨干骨折患者的疗效显著,可在有效促进患者肩关节活动度及功能恢复同时,降低手术风险及术后并发症发生风险,安全性更高。

Objective:To observe the effect of MIPO on upper limb function of patients with humeral shaft fracture and analyze the safety of operation.Methods:Taking 123 patients with humeral shaft fracture admitted to the hospital from January 2020 to February 2022 as the research objects.The enrolled patients were divided into two groups by drawing lots.61 patients treated with conventional therapy were listed as the control group,and 62 patients treated with MIPO were listed as the MIPO group.Perioperative clinical indicators and shoulder joint activity before and after treatment were compared between the two groups.All patients were followed up for 6 months.The recovery of shoulder joint function 1,3 and 6 months after operation and the complications during the follow-up were compared between the two groups.Results:The intraoperative blood loss,postoperative hospital stay and VAS score of MIPO group were lower than those of control group,with statistically significant difference(t=2.742,2.817,3.078;P<0.05).After treatment,the range of motion of shoulder joint in MIPO group was greater than that in control group,with statistically significant difference(t=3.295,2.241,2.774;P<0.05).The CMS and UCLA scores of MIPO group 1,3 and 6 months after operation were higher than those of the control group,with statistically significant difference(t=3.117,2.995,2.535;P<0.05).During the follow-up period,complication rate of MIPO group(4.84%)was lower than that of control group(14.75%),and the difference was statistically significant(χ^(2)=5.558,P<0.05).Conclusion:Compared with conventional surgery,MIPO has significant effect in the treatment of humeral shaft fracture.It can effectively promote the recovery of shoulder joint activity and function,and reduce the risk of surgery and postoperative complications.And it is safer.