关节镜引导下复位内固定治疗胫骨平台骨折的疗效和对患者膝关节功能恢复及生活质量的影响

Effect of arthroscopic guided reduction and internal fixation on the fracture of the tibial plateau and the recovery of knee function and quality of life

摘要:

摘要：目的 研究关节镜引导下复位内固定对胫骨平台骨折（FTP）患者的疗效和膝关节功能恢复及生活质量的影响。方法 选取该院2016年8月－2018年3月收治的FTP患者104例，采用随机数字法将其分为观察组和对照组，每组52例。观察组行膝关节镜辅助切开复位内固定术，对照组患者行传统切开复位内固定术。比较两组患者的手术指标（切口长度、出血量、手术用时、术后引流量及下床时间）、骨生化指标[Ca2+、降钙素（CT）、骨形态发生蛋白（BMP）和骨特异性碱性磷酸酶（NBAP）]、治疗疗效、膝关节功能Lysholm评分、生活质量SF-36评分和并发症发生情况。结果 治疗前，两组患者骨生化指标、膝关节功能Lysholm评分、生活质量SF-36评分均无明显差异（P >0.05）。治疗后，观察组切口长度、出血量、术后引流量、下床时间、NBAP明显少于对照组（P <0.01），观察组手术时间、Ca2+、CT、BMP水平、Lysholm评分和SF-36评分均明显高于对照组（P <0.01）。观察组治疗有效率为90.38%，明显高于对照组80.77%（P <0.01）。观察组并发症发生率为11.54%，明显低于对照组28.84%（χ2 =4.69，P =0.002）。结论 关节镜引导下复位内固定能够明显提升FTP患者的疗效，促进膝关节功能恢复，改善患者骨代谢指标，提高患者的生活质量，值得向临床推广应用。

Abstract:

Abstract: Objective To study the effect of arthroscopic guided reduction and internal fixation on the fracture of the tibial plateau and the recovery of knee function and quality of life. Methods 104 FTP patients from August 2016 to March 2018 were randomly divided into observation group and control group, 52 cases in each. The observation group underwent knee arthroscopic assisted open reduction and internal fixation, and the control group underwent conventional open reduction and internal fixation. Surgical parameters (incision length, bleeding volume, time of surgery, postoperative drainage and bedtime), bone biochemical parameters (Ca2+, CT, BMP, NBAP) and therapeutic efficacy, knee function Lysholm score, life quality SF-36 score and complications occurrence were compared between the two groups. Results Before treatment, there were no significant differences in bone biochemical parameters, Lysholm scores, and quality of life SF-36 scores between the two groups (P > 0.05). After treatment, the incision length, blood loss, postoperative drainage volume, time to bed, and NBAP were significantly lower in the observation group than in the control group (P < 0.01). The observation time, the Ca2+, CT, BMP and Lysholm scores in the observation group, SF-36 The scores were significantly higher than the control group (P < 0.01). The effective rate of treatment in the observation group was 90.38%, which was significantly higher than that in the control group (80.77%) (P < 0.01). The complication rate in the observation group was 11.54%, which was significantly lower than that in the control group (28.84%) (χ2 = 4.69, P = 0.002). Conclusion Arthroscopic guided reduction and internal fixation can significantly increase the efficacy of patients with tibial plateau fractures, promote knee function recovery, improve bone metabolic markers in patients, and improve the patient’s quality of life.