微创接骨板内固定在四肢骨折并发应激性溃疡患者中的疗效观察及对生活质量的影响
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摘要
目的观察微创接骨板内固定在四肢骨折合并应激性溃疡患者中的临床效果及对生活质量的影响.方法选取2015-08/2016-12宁波市鄞州区第二医院收治的四肢骨折并发应激性溃疡患者90例,采用随机数字法分为对照组(n=45)和观察组(n=45).2组患者均给予铝镁联合兰索拉唑治疗应激性溃疡.对照组采用传统内固定术治疗,观察组采用微创接骨板内固定治疗,采用世界卫生组织生活质量问卷调查表对患者躯体功能、心理功能、社会功能及物质生活质量进行评估,比较两组临床疗效及对生活质量的影响.结果观察组手术时间、切口愈合时间,短于对照组(P<0.05);观察组术中出血量、切口长度,少于对照组(P<0.05);观察组治疗后躯体功能、心理功能、社会功能及物质生活评分,高于对照组(P<0.05);观察组术后并发症发生率为4.44%,对照组为13.33%,两组术后并发症发生率比较差异有统计学意义(P<0.05).结论四肢骨折并发应激性溃疡患者在常规治疗基础上联合微创接骨板内固定治疗效果理想,能改善患者生活质量,可为临床提供借鉴.
AIM To observe the clinical effect of minimally invasive bone plate fixation in patients with limb fracture complicated with stress ulcer and its effect on quality of life.METHODS Ninety limb fracture patients complicated with stress ulcer treated from August 2015 to December 2016 were selected and randomly divided into a control group(n =45) and an observation group(n = 45). Both groups of patients were given aluminium magnesium carbonate plus lansoprazole for treatment of stress ulcer. The control group adopted traditional internal fixation, and the observation group was treated by minimally invasive plate internal fixation. Physical function, psychological function, social function and quality of life were assessed using the World Health Organization quality of life questionnaire. Clinical curative effect and quality of life were compared between the two groups.RESULTS Operative time and wound healing time were significantly shorter in the observation group than in the control group(P < 0.05). Blood loss and incision length of the observation group were significantly less than those of the control group(P < 0.05). The scores of physical function, psychological function, social function and quality of life were significantly better in the observation group than in the control group(P < 0.05). The incidence of postoperative complications was 4.44% in the observation group and 13.33% in the control group, and there was a significant between the two groups(P < 0.05).CONCLUSION Minimally invasive plate internal fixation combined with routine treatment has good efficacy and can improve quality of life in limb fracture patients complicated with stress ulcer.
AIM To observe the clinical effect of minimally invasive bone plate fixation in patients with limb fracture complicated with stress ulcer and its effect on quality of life.METHODS Ninety limb fracture patients complicated with stress ulcer treated from August 2015 to December 2016 were selected and randomly divided into a control group(n =45) and an observation group(n = 45). Both groups of patients were given aluminium magnesium carbonate plus lansoprazole for treatment of stress ulcer. The control group adopted traditional internal fixation, and the observation group was treated by minimally invasive plate internal fixation. Physical function, psychological function, social function and quality of life were assessed using the World Health Organization quality of life questionnaire. Clinical curative effect and quality of life were compared between the two groups.RESULTS Operative time and wound healing time were significantly shorter in the observation group than in the control group(P < 0.05). Blood loss and incision length of the observation group were significantly less than those of the control group(P < 0.05). The scores of physical function, psychological function, social function and quality of life were significantly better in the observation group than in the control group(P < 0.05). The incidence of postoperative complications was 4.44% in the observation group and 13.33% in the control group, and there was a significant between the two groups(P < 0.05).CONCLUSION Minimally invasive plate internal fixation combined with routine treatment has good efficacy and can improve quality of life in limb fracture patients complicated with stress ulcer.
引文
1王国旗,龙安华,张立海,张昊,尹鹏,唐佩福.老年髋部骨折合并糖尿病患者围手术期血糖水平对预后的影响.中国修复重建外科杂志2014;28:844-847
2黄丽杨,杨博宇,刘永前.267例胫骨骨折手术治疗术后切口并发症的危险因素分析.中国卫生统计2014;31:465-467
3肖志林,周明昌,冯经旺,刘天强.微创经皮钢板接骨术结合锁定加压钢板与切开复位解剖型钢板内固定治疗胫骨远端骨折的疗效比较.中华创伤骨科杂志2014;16:91-92
4包远祥,苏忠林,刘悦臣,熊天平.胫骨远端骨折患者的手术治疗方案研究.中国现代医学杂志2014;24:92
5储辉,俞航,黄洪.创经皮钢板接骨术联合锁定加压钢板治疗胫骨远端骨折临床效果分析.中国现代医学杂志2013;23:89-91
6 Yaligod V,Rudrappa GH,Nagendra S,Shivanna UM.Minimizing the complications of intramedullary nailing for distal third tibial shaft and metaphyseal fractures.J Orthop 2014;11:10-18[PMID:24719527 DOI:10.1016/j.jor.2013.12.002]
7 Li Y,Jiang X,Guo Q,Zhu L,Ye T,Chen A.Treatment of distal tibial shaft fractures by three different surgical methods:a randomized,prospective study.Int Orthop 2014;38:1261-1267[PMID:24549966 DOI:10.1007/s00264-014-2294-1]
8周江军,赵敏,杨俊,高伟,史柏娜,付美清,熊斌,余专一.微创骨膜下隧道锁定接骨板内固定技术治疗骨盆前环骨折.中国骨与关节杂志2013;9:62-63
9冯仕华,陈转,郑开达.微创接骨板技术治疗50例四肢骨折患者的临床疗效分析.辽宁医学院学报2013;34:160-161
10柯阳春.微创锁定加压接骨板内固定对胫骨骨折的疗效评价.中国医药科学2014;22:69
11杨经慧.微创经皮钢板内固定结合桥接钢板技术治疗股骨中下段骨折临床分析.中国卫生产业2013;10:108
12杨君,解建.应激性溃疡的发病机制研究.中国急救医学2007;27:1035-1038
13陈灏珠,林果为.实用内科学.第13版.北京:人民卫生出版社,2009:1985
14石剑峰.应激性溃疡防治的研究进展.现代预防医学2013;40:166-167
15张永来,段瑞德.微创锁定加压接骨板内固定治疗86例胫骨骨折的临床疗效.中国医科大学学报2014;(10):36-38
16朱玉梅,张显英.微创经皮钢板内固定结合桥接钢板技术治疗股骨中下段骨干骨折.医药论坛杂志2014;32:126-128
17吴学元,马巍,任国文,王振汉.锁定加压钢板治疗四肢骨折的临床应用.中国骨与关节损伤杂志2014;29:138-139
18 Jha AK,Bhattacharyya A,Kumar S,Ghosh TK.Evaluation of results of minimally invasive plate osteosynthesis(MIPO)of distal tibial fractures in adults.J Indian Med Assoc 2012;110:823-824[PMID:23785920]
2黄丽杨,杨博宇,刘永前.267例胫骨骨折手术治疗术后切口并发症的危险因素分析.中国卫生统计2014;31:465-467
3肖志林,周明昌,冯经旺,刘天强.微创经皮钢板接骨术结合锁定加压钢板与切开复位解剖型钢板内固定治疗胫骨远端骨折的疗效比较.中华创伤骨科杂志2014;16:91-92
4包远祥,苏忠林,刘悦臣,熊天平.胫骨远端骨折患者的手术治疗方案研究.中国现代医学杂志2014;24:92
5储辉,俞航,黄洪.创经皮钢板接骨术联合锁定加压钢板治疗胫骨远端骨折临床效果分析.中国现代医学杂志2013;23:89-91
6 Yaligod V,Rudrappa GH,Nagendra S,Shivanna UM.Minimizing the complications of intramedullary nailing for distal third tibial shaft and metaphyseal fractures.J Orthop 2014;11:10-18[PMID:24719527 DOI:10.1016/j.jor.2013.12.002]
7 Li Y,Jiang X,Guo Q,Zhu L,Ye T,Chen A.Treatment of distal tibial shaft fractures by three different surgical methods:a randomized,prospective study.Int Orthop 2014;38:1261-1267[PMID:24549966 DOI:10.1007/s00264-014-2294-1]
8周江军,赵敏,杨俊,高伟,史柏娜,付美清,熊斌,余专一.微创骨膜下隧道锁定接骨板内固定技术治疗骨盆前环骨折.中国骨与关节杂志2013;9:62-63
9冯仕华,陈转,郑开达.微创接骨板技术治疗50例四肢骨折患者的临床疗效分析.辽宁医学院学报2013;34:160-161
10柯阳春.微创锁定加压接骨板内固定对胫骨骨折的疗效评价.中国医药科学2014;22:69
11杨经慧.微创经皮钢板内固定结合桥接钢板技术治疗股骨中下段骨折临床分析.中国卫生产业2013;10:108
12杨君,解建.应激性溃疡的发病机制研究.中国急救医学2007;27:1035-1038
13陈灏珠,林果为.实用内科学.第13版.北京:人民卫生出版社,2009:1985
14石剑峰.应激性溃疡防治的研究进展.现代预防医学2013;40:166-167
15张永来,段瑞德.微创锁定加压接骨板内固定治疗86例胫骨骨折的临床疗效.中国医科大学学报2014;(10):36-38
16朱玉梅,张显英.微创经皮钢板内固定结合桥接钢板技术治疗股骨中下段骨干骨折.医药论坛杂志2014;32:126-128
17吴学元,马巍,任国文,王振汉.锁定加压钢板治疗四肢骨折的临床应用.中国骨与关节损伤杂志2014;29:138-139
18 Jha AK,Bhattacharyya A,Kumar S,Ghosh TK.Evaluation of results of minimally invasive plate osteosynthesis(MIPO)of distal tibial fractures in adults.J Indian Med Assoc 2012;110:823-824[PMID:23785920]