摘要
目的探讨损伤程度对胫骨平台骨折患者手术治疗效果及预后的影响。方法选择2018年1月至2020年6月我院收治的80例胫骨平台骨折患者为研究对象,按照损伤程度将其分为A组(40例,SchatzkerⅠ~Ⅲ型)和B组(40例,SchatzkerⅣ~Ⅵ型)。所有患者均实施切开复位内固定术,根据损伤程度决定切口位置。比较两组的血清炎症因子水平、疼痛评分、并发症发生情况、离床活动时间、住院时间、膝关节功能评分、膝关节屈伸度、舒适度评分、睡眠质量评分和生活质量评分。结果术后第1、2、3天,两组的C反应蛋白、白细胞介素-6水平比较,差异均无统计学意义(P>0.05)。术后12、24、36、48 h,两组的VAS评分比较,差异均无统计学意义(P>0.05)。两组的术后并发症总发生率、离床活动时间、住院时间比较,差异均无统计学意义(P>0.05)。手术后,两组的LKSS评分高于手术前、膝关节屈伸度大于手术前,且A组优于B组(P<0.05)。手术后,两组的GCQ评分均高于手术前,PSQI评分均低于手术前,且A组优于B组(P<0.05)。手术后,两组的生理领域、心理领域、环境领域、社会关系评分均高于手术前,且A组高于B组(P<0.05)。结论胫骨损伤程度不会增加胫骨平台骨折患者切开复位内固定术后的并发症发生情况,对其术后疼痛程度及住院时间也无明显影响,但胫骨损伤程度会影响患者的术后膝关节恢复情况和生活质量,损伤程度越轻,患者的膝关节功能恢复效果越好,预后越好。
Objective To investigate the influences of injury degree on surgical treatment effect and prognosis of patients with tibial plateau fracture.Methods A total of 80 patients with tibial plateau fractures treated in our hospital from January 2018 to June 2020 were selected as the study objects and divided into group A(40 cases,Schatzker typeⅠ-Ⅲ)and group B(40 cases,Schatzker typeⅣ-Ⅵ)according to injury degree.All patients underwent open reduction and internal fixation,and the incision position was determined according to the injury degree.The levels of serum inflammatory factors,pain score,occurrence of complications,out of bed activity time,hospital stay,knee function score,knee flexion and extension,comfort score,sleep quality score and quality of life score were compared between the two groups.Results At 1,2,3 d after operation,there were no significant differences in the levels of C-reactive protein and interleukin-6 between the two groups(P>0.05).At 12,24,36 and 48 h after operation,there was no significant difference in pain score between the two groups(P>0.05).There were no significant differences in the total incidence of postoperative complications,out of bed activity time and hospital stay between the two groups(P>0.05).After operation,the LKSS score was higher than that before operation in the two groups,and knee flexion and extension was greater than that of the before operation,and those of the group A were better than the group B(P<0.05).After operation,the GCQ score of the two groups was higher than that before operation,the PSQI score was lower than that before operation,and those in the group A were better than the group B(P<0.05).After operation,the scores of physiological field,psychological field,environmental field and social relationship in the two groups were higher than those before operation,and those in the group A were higher than the group B(P<0.05).Conclusion The degree of tibial injury will not increase the occurrence of complications after open reduction and internal fixation in patients with tibial plateau fracture,and has no significant impact on the degree of postoperative pain and hospital stay.However,the degree of tibial injury will affect the postoperative knee recovery and quality of life.The lighter the injury degree,the better the recovery effect of knee function and the better the prognosis.
作者
刘冲
高鑫
杨志奎
李鹏
田涛
LIU Chong;GAO Xin;YANG Zhikui;LI Peng;TIAN Tao(Xianyang Hospital of Yan'an University,Xianyang 712000,China)
出处
《临床医学研究与实践》
2022年第8期56-59,共4页
Clinical Research and Practice
关键词
胫骨平台骨折
切开复位内固定术
损伤程度
膝关节功能
tibial plateau fracture
open reduction and internal fixation
injury degree
knee function
