文章摘要
许腾飞,申文瀚,邓 淼,龙 毅,李文博.弹性髓针在青少年锁骨中段骨折治疗中的应用研究[J].,2020,(12):2338-2341
弹性髓针在青少年锁骨中段骨折治疗中的应用研究
Application of Elastic Marrow Needle in Treatment of Midshaft Clavicle Fracture in Adolescents
投稿时间:2019-10-25  修订日期:2019-11-21
DOI:10.13241/j.cnki.pmb.2020.12.030
中文关键词: 弹性髓针  青少年  锁骨中段骨折  凝血功能  疼痛  肩关节功能
英文关键词: Elastic marrow needle  Adolescent  Middle clavicle fracture  Coagulation function  Pain  Shoulder function
基金项目:重庆市卫生和计划生育委员会面上项目(20162630)
作者单位E-mail
许腾飞 武警重庆市总队医院骨科 重庆 400061 18523452167@163.com 
申文瀚 武警重庆市总队医院骨科 重庆 400061  
邓 淼 武警重庆市总队医院骨科 重庆 400061  
龙 毅 武警重庆市总队医院骨科 重庆 400061  
李文博 武警重庆市总队医院骨科 重庆 400061  
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中文摘要:
      摘要 目的:回顾性研究弹性髓针(EMN)在青少年锁骨中段骨折(MCF)治疗中的应用效果。方法:纳入2016年1月-2019年6月于我院接受治疗的MCF患者66例,依据手术方法分为EMN组(n=35)与锁定钢板内固定(LPF)组(n=31)。EMN组行EMN治疗,LPF组行LPF治疗。观察两组术中出血量、手术时间、切口长度、住院时间、骨折愈合时间等手术相关指标。比较两组术前及术后3 d纤维蛋白原(Fg)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)等凝血功能指标。比较两组术前及术后7 d视觉模拟量表(VAS)评分及血清去甲肾上腺素(NE)、五羟色胺(5-HT)、P物质(SP)水平。比较两组术前及术后30 d肩关节活动度及肩关节功能评分,记录两组术后并发症。结果:EMN组术中出血量少于LPF组,手术时间、切口长度、住院时间短于LPF组(P<0.05);两组骨折愈合时间无差异(P>0.05)。术后3 d,EMN组PT水平高于LPF组,Fg、APTT水平均低于LPF组(P<0.05)。术后7 d,EMN组VAS评分、5-HT、SP、NE水平均低于LPF组(P<0.05)。术后30 d,两组肩外展、肩前屈活动度及肩关节功能评分均无差异(P>0.05)。EMN组术后并发症发生率低于LPF组。结论:EMN治疗青少年MCF创伤小,对机体凝血功能影响小,可有效缓解患者术后疼痛,促进患者肩关节功能恢复,降低术后并发症发生风险。
英文摘要:
      ABSTRACT Objective: A retrospective study was conducted to analyze the therapeutic effect of Elastic marrow needle (EMN) on middle clavicle fracture (MCF) in adolescents. Methods: 66 MCF patients admitted to our hospital from January 2016 to June 2019, they were divided into EMN group (n=35) and locking plate internal fixation (LPF) group (n=31) according to the method of operation. EMN group was treated with EMN, LPF group was treated with LPF. The intraoperative bleeding volume, operation time, incision length, hospitalization time and fracture healing time were observed between the two groups. Fibrinogen (Fg), prothrombin time (PT) and activated partial prothrombin time (APTT) were compared before and 3 days after operation between the two groups. The visual analogue scale (VAS) scores before and 7 days after operation and the levels of serum norepinephrine (NE), 5-hydroxytryptamine (5-HT), substance P (SP) were compared between the two groups. The shoulder motion and shoulder function scores between the two groups before and 30 days after operation were compared, postoperative complications were recorded between the two groups. Results: The intraoperative bleeding volume in EMN group was less than that in LPF group, the operation time, incision length, hospitalization time were shorter than that in LPF group (P<0.05), there was no difference in fracture healing time between the two groups (P>0.05). 3 d after operative, the level of PT in LFP group was higher than that in LPF group, the levels of Fg, APTT in LFP group were lower than those in LPF group (P<0.05). 7 d after operative, the VAS scores, the levels of 5-HT, SP, NE in LFP group were lower than those in LPF group (P<0.05). 30 d after operative, there was no difference in shoulder abduction, shoulder flexion range of motion and shoulder joint function score between the two groups (P>0.05). The incidence of postoperative complications in EMN group was lower than that in LPF group. Conclusion: EMN treatment of adolescent MCF has less trauma and less influence on coagulation function. It can effectively relieve postoperative pain, promote shoulder function recovery and reduce the risk of complications.
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