膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、sVCAM和ALP水平的影响.docx

《膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、sVCAM和ALP水平的影响.docx》由会员分享，可在线阅读，更多相关《膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、sVCAM和ALP水平的影响.docx（6页珍藏版）》请在第一文库网上搜索。

1、膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清NGF、SVCAM和A1P水平的影响何鹏马拓*杜俊伟王斌石海浪西电集团医院骨科陕西西安710077通讯作者：马拓。摘要目的研究膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效及对血清神经生长因子(NGF)、血管细胞黏附因子(SVCAM),碱性磷酸酶(A1P)水平的影响。方法选择2019年2月至2023年2月我院60例胫骨平台骨折患者进行研究。按照简单抽签法分为研究组和对照组，各30例，对照组采用传统切开复位内固定术治疗，研究组采用膝关节镜下有限切开骨折庭位内固定术治疗。比较两组治疗3个月后治疗优良率，术后恢复情况(手术切口

2、长度、骨折愈合时间、关节活动度)，治疗前及治疗3个月后Rasmussen和VAS评分、血清NGF、SVCAM和A1P水平，记录分析两组住院期间的并发症发生率。结果研究组的治疗优良率为86.66%,明显高于对照组的60.00%,差异有统计学意义(P0.05)；研究组切口长度、手术时间、术中出血量、术后引流软、卜床时间分别为(7.851.40)cm,(81.908.46)min,(78.6016.21)M1,(31.293.28)d,(3.670.85)d均明显低于对照组I(15.603.91)cm,(107.5611.87)min,(96.3OI9.32)M1,(41.896.23)d,(5.1

3、81.20)d,差异有统计学意义(PVO.05)；研究组手术切口长度、骨折愈合时间分另IJ为(5.811.23)cm、(3.100.52)月，均明显短于对照组的(19.023.6DCm、(5.890.71)月,研究组的关节活动度为(126.75+15.62)。，明显高于对照组的(118.63+13.29),差异有统计学意义(PVo.05)；研究组RaSmUSSen评分为(95.036.87)分，明显高于对照组的(82.654.32)分,差异具有统计学意义(PVO.05)；研究组VAS评分为(3.090.52)分，明显低于对照组的(5.611.03)分，差异具有统计学意义(PVO.05)；研究组

4、NGF、A1P水平分别为(1.360.32)mg1.(275.8660.32)U/1,均明显高于对照组的(0.890.27)mg1.(I9O.7647.69)U/1,差异有统计学意义(PVO.05)；研究组并发症发生率为3.33%,明显低于对照组23.33%,差异有统计学意义(PVO.05).结论膝关节镜下有限切开骨折复位内固定术治疗胫骨平台骨折的疗效显著，可促进骨愈合，减轻炎症因子NGF、sVCAM.A1P水平，降低术后并发症，利于术后早期功能锻炼.【关键词】膝关节镜下；有限切开骨折复位内固定术；胫骨平台骨折；炎症反应；并发症Theeffectof1imitedincisionfractur

5、ereductionandinterna1fixationunderarthroscopyontibia1p1ateaufractureandtheinf1uenceonserumNGF,sVCAMandA1P1eve1sHepengmatuo*dujunweiwangbinShihai1angDepartmentofOrthopedicsXidianHospita1ShanxiXi,an710077AbstractObjectiveTostudytheeffectof1imitedincisionfracturereductionandinterna1fixationunderarthros

6、copyontibia1p1ateaufractureandtheinf1uenceonserumNGF,sVCAMandA1P1eve1s.Methods60patientswithtibia1p1ateaufracturewhoreceivedtreatmentinourhospita1fromFebruary2018toFebruary2023werese1ectedforthisstudy.Theyweredividedintostudygroupandcontro1groupwith30casesineachgroup.Thecontro1groupwastreatedwithtra

7、ditiona1openreductionandinterna1fixation,Thestudygroupwastreatedwith1imitedopenreductionandinterna1fixationunderkneearthroscope.Theexce11entrate,postoperativerecovery(incision1ength,fracturehea1ingtime,jointactivity)werecomparedinthetwogroupsafter3months,andtheRasmussenandVASscores,serumNGF,sVCAMand

8、A1P1eve1swerecomparedbeforeandafter3months,theincidenceofcomp1icationsinthetwogroupsduringhospita1izationwasrecordedandana1yzed.Resu1tsTheexce11entandgoodrateofthestudygroupwas86.66%,whichwassignificant1yhigherthanthatofthecontro1group60.00%,thedifferencewasstatistica11ysignificant(P0.05);Theincisio

9、n1ength,operationtime,intraoperativeb1eeding,postoperativedrainagevo1umeandoutofbedtimeinthestudygroupwere(7.851.40)cm,(81.908.46)min,(78.6016.21)M1,(31.293.28)d,(3.670.85)djwassignificant1y1owerthanthecontro1group(15.603.91)cm,(107.5611.87)min,(96.3019.32)M1,(41.896.23)d,(5.I81.2O)d,thedifferencewa

10、sstatistica11ySignifiCant(PVo.05)he1engthofincisionandfracturehea1ingtimeofthestudygroupwere(5.811.23)cm,(3.100.52)month,whichwassignificant1yshorterthanthatofthecontro1group(19.023.61)cm,(5.890.71)month,therangeofmotionofthestudygroupwas(126.7515.62),whichwassignificant1yhigherthanthatofthecontro1g

11、roup(118.6313.29),thedifferencewasstatistica11ysignificant(P0.05);therasmussenscoreofthestudygroupwas(95.036.87)scores,whichwassignificant1yhigherthanthatofthecontro1group(82.654.32)scores,thedifferencewasstatistica11ysignificant(P0.05);theVASscoreofthestudygroupwas(3.090.52)scoreswassignificant1ysh

12、orterthanthatofthecontro1group(5.611.03)scores,thedifferencewasstatistica11ysignificant(P0.05);the1eve1sofNGFandA1Pinthestudygroupwere(1.360.32)mg1,(275.8660.32)UUWaSsignificant1yhigherthanthatofthecontro1group(0.890.27)mg1,(190.7647.69)U1,thedifferencewasstatistica11ysignificant(P0.05);theincidenceofcomp1icationsinthestudygroupwas3.33%,whichwassignificant1y1owerthanthatofthecontro1group23.33%,thedifferencewasstatistica11ysignificant(P0.05）,见表1。表1两组一般资料对比Us）组例性别年龄受伤SChatZker分型致伤原因合并损伤别数(男/（岁）至入I型H型In型扭摔交半月前交叉内侧女）院时伤伤通板游韧带胫副韧间(d)事离侧止点带断