肘关节恐怖三联征围术期激素的应用效果

发布时间：2018-03-28 07:48

本文选题：恐怖三联征　切入点：围术期　出处：《中国老年学杂志》2017年13期

【摘要】：目的探讨肘关节恐怖三联征患者围术期激素的应用对其术后疼痛、运动功能以及并发症的影响。方法 17例围术期应用激素的患者为激素组,17例无激素用药史的患者为对照组,激素组术中给予地塞米松10 mg静脉推注,术后6 d逐渐减量口服甲强龙。两组术后均前臂旋前位屈肘90°石膏外固定2 w后拆除外固定开始行肘关节功能锻炼,在术后的2、6、12、24 w分别记录并评估各组患者的疼痛评分、肘关节活动度及各种并发症的发生情况。结果术后24 w时激素组比对照组患肢的屈伸角度更大(P0.05),24 w前的随访中两组数据无显著差异(P0.05)。所有时间点激素组的前臂旋后角度均大于对照组(P0.05)。对照组有4种并发症,激素组有2种。最常见的并发症是异位骨化和尺神经麻痹,所有的异位骨化均发生在对照组,其中有1例需要手术干预。两组均无术后感染、骨折不愈合或延迟愈合发生。结论恐怖三联征患者围术期激素的应用有助于其术后肘关节的屈伸旋转功能的恢复,尤其是可以提高患肢的旋后功能,且激素的应用并不会增加患者术后的疼痛评分及感染发生率。
[Abstract]:Objective to investigate the effect of perioperative hormone application on postoperative pain, motor function and complications in patients with triple syndrome of elbow joint terror. Methods 17 patients with perioperative hormone use were treated with hormone group and 17 patients with no history of hormone use as control group. In the steroid group, dexamethasone 10 mg was given intravenously, and oral methylenolone was gradually reduced 6 days after operation. After 2 weeks of external fixation of 90 掳anteflexion of forearm, the external fixation was removed and the function of elbow joint was performed. Pain scores were recorded and evaluated 24 weeks after operation. Results at 24 weeks after operation, the angle of flexion and extension of the affected limbs in the hormone group was greater than that in the control group. There was no significant difference between the two groups in the data of the two groups at 24 weeks after operation, and there was no significant difference between the two groups at all time points in the forearm rotation of the hormone group. The posterior angle was higher than that in the control group (P 0.05). There were 4 kinds of complications in the control group. The most common complications were ectopic ossification and ulnar nerve palsy. All ectopic ossification occurred in the control group. Conclusion the perioperative hormone application in the patients with terrors syndrome is helpful to the recovery of elbow flexion and extension rotation function, especially to the improvement of circumflex function of the affected limbs. And the use of hormones did not increase postoperative pain score and incidence of infection.
【作者单位】：吉林大学第一医院创伤骨科;
【分类号】：R687.4

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