首页|MIPO治疗老年四肢骨折患者的效果及对骨代谢指标和应激指标的影响

MIPO治疗老年四肢骨折患者的效果及对骨代谢指标和应激指标的影响

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目的:探讨经皮微创钢板内固定术(MIPO)治疗老年四肢骨折患者的效果及对骨代谢指标和应激指标的影响。方法:回顾性选取 2021 年 6 月—2023 年 6 月中铁五局集团第二工程有限责任公司医院收治的 80 例老年四肢骨折患者。根据不同的手术方法将其分为MIPO组(n=40)与传统组(n=40)。MIPO组采用MIPO,传统组采用切开复位钢板内固定术。比较两组围手术期指标,并发症,术前、术后3 d应激指标、骨代谢指标及手术疗效。结果:MIPO组术中失血量少于传统组,手术时间和术后住院时间均短于传统组,差异有统计学意义(P<0。05)。MIPO组术后并发症低于传统组,差异有统计学意义(P<0。05)。术后 3 d,两组皮质醇(Cor)、白细胞介素-6(IL-6)和C反应蛋白(CRP)水平均升高,MIPO组Cor、IL-6和CRP水平均低于传统组,差异有统计学意义(P<0。05)。术后 3 d,两组Ⅰ型胶原羧基端肽β特殊序列(β-CTX)水平降低,Ⅰ型前胶原羧基端肽(PⅠCP)水平升高,MIPO组β-CTX水平低于传统组,PⅠCP水平高于传统组,差异有统计学意义(P<0。05)。MIPO组优良率高于传统组,差异有统计学意义(P<0。05)。结论:MIPO治疗老年四肢骨折患者效果显著,并发症少,且可改善患者骨代谢,对应激反应影响小。
Effect of MIPO in the Treatment of Elderly Patients with Limb Fracture and Its Influence on Bone Metabolism Index and Stress Index
Objective:To explore the effect of minimally invasive plate osteosynthesis(MIPO)in the treatment of elderly patients with limb fracture and its influence on bone metabolism index and stress index.Method:A total of 80 elderly patients with limb fracture admitted to China Railway Fifth Bureau Group Second Engineering Co.,Ltd.Hospital from June 2021 to June 2023 was retrospectively selected.They were divided into MIPO group(n=40)and traditional group(n=40)according to different surgical methods.MIPO group was treated with MIPO,traditional group was treated with open reduction plate internal fixation.The perioperative indexes,complications,preoperative and postoperative 3 d stress indexes,bone metabolism indexes and operative effects were compared between the two groups.Result:The intraoperative blood loss volume in MIPO group was less than that in traditional group,and the operative time and postoperative hospital stay were shorter than that in traditional group,the differences were statistically significant(P<0.05).The postoperative complications in MIPO group was lower than that in traditional group,and the difference was statistically significant(P<0.05).At 3 d after surgery,the levels of cortisol(Cor),interleukin-6(IL-6)and C-reactive protein(CRP)were increased in both groups,and the levels of Cor,IL-6 and CRP in MIPO group were lower than those in traditional group,the differences were statistically significant(P<0.05).At 3 d after surgery,the level of carboxy-terminal peptide β special sequence of type Ⅰ collagen(β-CTX)was decreased,and the level of carboxy-terminal peptide of type Ⅰ procollagen(PⅠCP)was increased in two groups,the level of β-CTX in MIPO group was lower than that in traditional group,and the PⅠCP level was higher than that in traditional group,the differences were statistically significant(P<0.05).The excellent and good rate of MIPO group was higher than that of traditional group,and the difference was statistically significant(P<0.05).Conclusion:MIPO has a significant therapeutic effect in the treatment of elderly patients with limb fractures,with fewer complications,and can improve bone metabolism and have little impact on stress response.

Minimally invasive plate osteosynthesisElderly limb fracturesBone metabolismStress indicators

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中铁五局集团第二工程有限责任公司医院 湖南 衡阳 421800

经皮微创钢板内固定术 老年四肢骨折 骨代谢 应激指标

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(16)