微创经皮内固定术与切开复位内固定术治疗胫骨骨折的效果及对并发症的影响

Effect of Minimally Invasive Percutaneous Internal Fixation and Open Reduction Internal Fixation in the Treatment of Tibial Fracture and Its Influence on Complications

目的:探究微创经皮内固定术与切开复位内固定术治疗胫骨骨折的效果及对并发症的影响。方法:回顾性选择2020年11月—2022年6月在九江学院附属医院、中国人民解放军联勤保障部队庐山康复疗养中心骨科就诊的68例胫骨骨折患者,按手术方式不同分为对照组(n=32)、研究组(n=36)。对照组行切开复位内固定术治疗,研究组行微创经皮内固定术治疗。比较两组手术相关指标、肢体功能恢复情况、疼痛应激指标及并发症发生情况。结果:研究组切口长度、手术时间、住院时间、骨折临床愈合时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。研究组肢体功能优良率为97.22%,高于对照组的78.13%,差异有统计学意义(P<0.05)。术后7 d,两组神经肽Y(NPY)、P物质(SP)均高于术前,但研究组NPY、SP均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症总发生率为5.56%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论:微创经皮内固定术较切开复位内固定术治疗胫骨骨折的效果更佳,可减少患者术后并发症发生,促进康复。

Objective:To explore the effect of minimally invasive percutaneous internal fixation and open reduction internal fixation on tibial fracture and its influence on complications.Method:A total of 68 patients with tibial fracture treated in the Department of Orthopedics of Jiujiang University Affiliated Hospital and Chinese People's Liberation Army Joint Logistic Support Force Lushan Rehabilitation and Recuperation Center from November 2020 to June 2022 were retrospectively selected,and they were divided into control group(n=32)and study group(n=36)according to different surgical methods.The control group underwent open reduction internal fixation,and the study group underwent minimally invasive percutaneous internal fixation.The surgery related indexes,limb function recovery,pain stress indexes and complications were compared between the two groups.Result:The incision length,surgery time,hospital stay and clinical healing time of fracture in the study group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).The excellent rate of limb function in the study group was 97.22%,which was higher than 78.13%in the control group,the difference was statistically significant(P<0.05).At 7 d after surgery,neuropeptide Y(NPY)and substance P(SP)in two groups were higher than those before surgery,but NPY and SP in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).The total complication rate of the study group was 5.56%,which was lower than 25.00%of the control group,the difference was statistically significant(P<0.05).Conclusion:Minimally invasive percutaneous internal fixation is more effective than open reduction internal fixation in the treatment of tibial fractures,which can reduce postoperative complications and promote recovery.