双侧钢板内固定治疗股骨远端骨折患者的疗效及其对血清ACTH、IL-10、hs-CRP水平的影响

摘要

目的 研究双侧钢板内固定治疗股骨远端骨折患者的疗效,探讨其对血清促肾上腺皮质激素(ACTH)、白介素-10(IL-10)、超敏C反应蛋白(hs-CRP)水平的影响.方法 选取2014年1月至2015年1月我院收治的136例股骨远端骨折患者资料作为研究对象,按照不同术式分为对照组(n=62)和观察组(n=74),对照组行单侧钢板内固定治疗,观察组行双侧钢板内固定治疗,比较两组手术的相关指标、临床疗效,并观察两组患者血清治疗前后的ACTH、IL-10、hs-CRP水平的变化.结果 观察组手术时间比对照组长,但骨折愈合时间少于对照组,差异均有统计学意义(P<0.05).观察组治疗优良率为97.30%,明显高于对照组的79.03%,并发症发生率低于对照组,差异均有统计学意义(P<0.05).与术前比较,两组术后BI指数评分均降低,但观察组降低的幅度较对照组更大,差异均有统计学意义(P>0.05).治疗前,两组患者血清ACTH、IL-10、hs-CRP水平比较差异均无统计学意义(P>0.05);治疗1个月末,观察组患者血清ACTH、IL-10、hs-CRP水平明显低于对照组,差异均有统计学意义(P<0.05).结论 股骨远端骨折患者行双侧钢板内固定治疗效果显著,并发症少,且可降低血清ACTH、IL-10、hs-CRP水平.%Objective To study the clinical effect of double plate internal fixation for fractures of distal femur and its significant influence on serum adrenocorticotropic hormone (ACTH), interleukin 10 (IL-10) and c-reactive pro-tein (hs-CRP). Methods A total of 136 cases of fractures of distal femur, who admitted to our hospital from January 2014 to January 2015, were selected and divided into the control group (n=62) and the observation group (n=74). The control group and the observation group were respectively treated with single plate and double plates. The surgical-related indicators and clinical efficacy of the two groups were compared, and the changes in serum hs-CRP, IL-10 and ACTH were also observed. Results The operation time of the observation group was significantly higher than that of the control group, but the fracture healing time was significantly lower than that of the control group (P<0.05). The excellent and good rate of the observation group was 97.30%, which was significantly higher than 79.03% of the control group (P<0.05). Compared with preoperative, the BI index score of the two groups decreased, but the amplitude of the observation group was significantly lower than the control group (P<0.05). Before treatment, there was no significant difference be-tween the two groups in the serum levels of ACTH, IL-10 and hs-CRP (P>0.05). After one month of treatment, the levels of serum ACTH, IL-10 and hs-CRP in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Double plate internal fixation has the advantages of remarkable effect and less complications in the treatment of patients with distal femoral fracture, which can effectively reduce the levels of serum ACTH, IL-10 and hs-CRP.