不同治疗方案在肱骨髁部骨不连合并骨缺损患者中的应用效果对比

发布时间：2018-05-20 04:35

本文选题：肱骨髁部骨不连合并骨缺损 + 自体富血小板血浆　；参考：《中国现代医学杂志》2017年11期

【摘要】：目的比较不同治疗方案在肱骨髁部骨不连合并骨缺损患者中的应用效果。方法选取2011年6月-2016年6月该院收治的62例肱骨髁部骨不连合并骨缺损患者为研究对象,采用随机数表法将患者分为观察组和对照组,各31例。对照组患者采用单纯髂骨移植对骨缺损进行重建,观察组患者采用自体富血小板血浆联合髂骨移植对骨缺损进行重建。比较两组患者的围术期各时间、肘关节活动度、Cassebaum评分及并发症发生率。结果观察组与对照组手术时间、住院天数、骨性愈合时间及临床愈合时间的比较,经t检验,差异有统计学意义(P0.05),观察组患者的手术时间、住院天数、骨性愈合时间及临床愈合时间均低于对照组患者。治疗前观察组与对照组肘关节屈和伸活动度比较经t检验差异无统计学意义(t=1.835和1.915,P=0.075和0.067)。治疗后观察组与对照组肘关节屈和伸活动度比较经t检验差异有统计学意义(t=2.377和2.549,P=0.033和0.016),观察组患者屈活动度高于对照组患者,伸活动度低于对照组患者。治疗后观察组优良率80.63%,对照组优良率77.41%,经χ~2检验,差异无统计学意义(χ~2=1.653,P=0.081)。治疗后,观察组31例患者中1例延迟愈合,1例褥疮,对照组31例患者中2例延迟愈合,2例褥疮,2例深静脉血栓,观察组并发症发生率6.45%(2/31),对照组患者的并发症发生率19.35%(6/31),经χ~2检验,差异有统计学意义(χ~2=6.035,P=0.030),对照组患者的并发症发生率高于观察组患者。结论给予肱骨髁部骨不连合并骨缺损患者自体富血小板血浆联合髂骨移植治疗较单纯髂骨移植治疗术后恢复快,修复效果好,可以在临床上进一步推广和使用。
[Abstract]:Objective to compare the effect of different treatment schemes in the patients with bone nonunion and bone defect in the condyle of humerus. Methods 62 cases of humerus condylar bone nonunion and bone defect were selected in June 2011 -2016 years in June. The patients were divided into observation group and control group by random number table method, each with 31 cases. Bone defect was reconstructed with pure iliac bone graft. The patients in the observation group were rebuilt with autogenous platelet rich plasma and iliac bone graft to reconstruct the bone defect. The perioperative period of the two groups, the elbow joint activity, the Cassebaum score and the incidence of complications were compared. The operative time, the days of hospitalization, the time of bone union and the time of bone healing were compared with the control group. The comparison of clinical healing time was statistically significant (P0.05) by t test. The operation time, hospital days, bone healing time and clinical healing time of the observation group were lower than those of the control group. There was no significant difference between the elbow flexion and extension activity of the observation group and the control group compared with the t test before the treatment (t=1.835 and 1.915, P=0.07). 5 and 0.067). After treatment, the differences of elbow flexion and extension activity between the observation group and the control group were statistically significant (t=2.377 and 2.549, P=0.033 and 0.016). The flexion degree of the observation group was higher than that of the control group, and the extension activity was lower than that of the control group. The excellent rate of the observation group was 80.63%, the good rate of the control group was 77.41%, and the X ~2 test was performed after the treatment. The difference was not statistically significant (x ~2=1.653, P=0.081). After the treatment, 1 of the 31 patients in the observation group were delayed union, 1 cases of bedsore, 2 cases of delayed union in the control group, 2 cases of bedsore, 2 cases of deep venous thrombosis, the incidence of complications in the observation group was 6.45% (2/31), and the incidence of complications in the control group was 19.35% (6/31), and the difference was statistically significant by the chi square test. The difference was statistically significant Significance (x ~2=6.035, P=0.030), the incidence of complications in the control group was higher than that in the observation group. Conclusion the combined treatment of autologous platelet rich plasma and iliac bone graft for the patients with bone defect of the humerus condyle and bone defect is faster than that of the simple iliac bone graft, and the effect is better and can be further promoted and used in clinical.
【作者单位】：青海省人民医院骨科;
【分类号】：R687.3

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