| 李 稳,李兴华,方 庆,汪国栋,蔡贤华.两种内固定方法治疗老年骨盆后环骨折的疗效对比及对血清应激因子和疼痛相关生化指标的影响[J].,2022,(13):2504-2508 |
| 两种内固定方法治疗老年骨盆后环骨折的疗效对比及对血清应激因子和疼痛相关生化指标的影响 |
| Comparison of Efficacy of Two Internal Fixation Methods in the Treatment of Elderly Posterior Pelvic Ring Fractures and Their Effects on Serum Stress Factors and Pain Related Biochemical Indexes |
| 投稿时间：2022-01-07 修订日期：2022-01-30 |
| DOI：10.13241/j.cnki.pmb.2022.13.020 |
| 中文关键词: 老年 骨盆后环骨折 3D导航下经皮骶髂关节螺钉内固定 后路微创重建钢板内固定 疗效 应激因子 疼痛 |
| 英文关键词: Elderly Posterior pelvic ring fracture 3D guided percutaneous sacroiliac screw internal fixation Posterior minimally invasive reconstruction plate internal fixation Efficacy Stress factors Pain |
| 基金项目:湖北省卫生健康委员会联合基金项目（WJ2018H0086） |
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| 摘要 目的：对比3D导航下经皮骶髂关节螺钉内固定、后路微创重建钢板内固定两种内固定方法治疗老年骨盆后环骨折的疗效及对血清应激因子和疼痛相关生化指标的影响。方法：回顾性分析2016年7月~2020年9月期间我院收治的100例老年骨盆后环骨折患者的临床资料。根据手术方式的不同将患者分为A组（n=50，后路微创重建钢板内固定）和B组（n=50，3D导航下经皮骶髂关节螺钉内固定）。对比两组手术相关指标、疼痛情况、Majeed功能评分、血清应激因子和疼痛相关生化指标变化情况。结果：B组术后3 d、术后1个月、术后3个月、术后1年视觉疼痛模拟评分（VAS）评分低于A组（P<0.05）。B组术中出血量少于A组，住院时间、手术时间、手术切口长度短于A组，但X线暴露时间长于A组（P<0.05）。B组术后1年Majeed功能评分高于A组（P<0.05）。B组术后7 d促甲状腺激素（TSH）水平高于A组，皮质醇（Cor） 、肾上腺素（E）水平低于A组（P<0.05）。B组术后7 d 5-羟色胺（5-HT）、P物质（SP）、前列腺素E2（PGE2）水平低于A组（P<0.05）。A组、B组的并发症发生率组间对比无显著性差异（P>0.05）。结论：与后路微创重建钢板内固定治疗老年骨盆后环骨折患者相比，3D导航下经皮骶髂关节螺钉内固定具有创伤小、手术时间短、术中出血量少、疼痛减轻、应激反应轻等诸多优势，可促进患者术后恢复。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of 3D guided percutaneous sacroiliac screw internal fixation and posterior minimally invasive reconstruction plate internal fixation in the treatment of elderly posterior pelvic ring fractures and their effects on serum stress factors and pain related biochemical indexes. Methods: The clinical data of 100 elderly patients with posterior pelvic ring fractures who were treated in our hospital from July 2016 to September 2020 were analyzed retrospectively. The patients were divided into group A (n=50, posterior minimally invasive reconstruction plate internal fixation) and group B (n=50, 3D guided percutaneous sacroiliac screw internal fixation) according to different surgical methods. The changes of operation related indexes, pain situation, Majeed function score, serum stress factors and pain related biochemical indexes were compared between the two groups. Results: The visual pain analogue scale (VAS) scores of group B at 3 d after operation, 1 month after operation, 3 months after operation and 1 year after operation were lower than those of group A (P<0.05). The intraoperative blood loss of group B was less than that of group A, the hospital stay, operation time and operation incision length of group B were shorter than those of group A, but the X-ray exposure time was longer than that of group A(P<0.05). 1 year after operation, the Majeed function score of group B was higher than that of group A(P<0.05). The levels of thyroid stimulating hormone (TSH) of group B at 7 d after operation were higher than those of group A, and the levels of cortisol (Cor) and epinephrine(E) were lower than those of group A(P<0.05). The levels of 5-hydroxytryptamine(5-HT), substance P(SP) and prostaglandin E2 (PGE2) of group B at 7 d after operation were lower than those of group A(P<0.05). There was no significant difference in the incidence of complications between group A and group B(P>0.05). Conclusion: Compared with posterior minimally invasive reconstruction plate internal fixation in the treatment of elderly patients with posterior pelvic ring fractures, 3D guided percutaneous sacroiliac screw internal fixation has many advantages, such as less trauma, shorter operation time, less intraoperative bleeding, less pain and less stress response, which can promote the postoperative recovery of patients. |
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