外固定支架联合负压封闭引流治疗开放性胫腓骨骨折的创伤程度及骨代谢情况评估

摘要

目的:评估外固定支架联合负压封闭引流对开放性胫腓骨骨折患者创伤程度及骨代谢的影响.方法:2015年2月~2017年1月间在泸州市人民医院接受手术治疗的开放性胫腓骨骨折患者116例,经随机数表法将入组患者分为对照组、研究组各58例.对照组患者接受清创术+外固定支架治疗,研究组患者接受清创术+外固定支架+负压封闭引流治疗.对比两组患者手术前后创伤指标、骨代谢指标含量的差异.结果:术前,两组患者血清中创伤指标、骨代谢指标含量的差异无统计学意义(P>0.05).术后1周,研究组患者血清中急性时相反应蛋白Tf的含量高于对照组患者,CER、Hp、CRP的含量低于对照组患者;应激指标NE、Cor的含量低于对照组患者;骨代谢指标P1NP、BGP、BALP的含量高于对照组患者,β-CTX的含量低于对照组患者.结论:开放性胫腓骨骨折患者接受外固定支架联合负压封闭引流治疗,可有效减轻骨折创伤并促进骨折端愈合.%Objective:To evaluate the effect of external fixation combined with vacuum sealing drainage on the trauma degree and bone metabolism in patients with open tibiofibula fracture. Methods:116 patients with open tibiofibula fracture who received surgical treatment in Luzhou People's Hospital between February 2015 and January 2017 were divided into control group(n=58)and study group(n=58)by random number table. Control group received debridement + external fixation, and study group received debridement + external fixation + vacuum sealing drainage. The differences in the levels of trauma indexes and bone metabolism indexes were compared between the two groups before and after treatment. Results:Before sur-gery,there was no statistically significant difference in serum levels of trauma indexes and bone metabolism indexes between the two groups(P>0.05). 1 week after surgery,serum acute phase protein Tf level of study group was higher than that of control group whereas CER,Hp and CRP levels were lower than those of control group;stress indexes NE and Cor levels were lower than those of control group;bone metabolism indexes P1NP,BGP and BALP levels were higher than those of control group whereas β-CTX level was lower than that of control group. Conclusion:External fixation combined with vacuum sealing drainage can effectively reduce fracture trauma and promote fracture end healing in patients with open tibiofibula fracture.