發(fā)布時間：2018-05-20 04:35

  本文選題：肱骨髁部骨不連合并骨缺損 + 自體富血小板血漿　； 參考：《中國現(xiàn)代醫(yī)學(xué)雜志》2017年11期

【摘要】：目的比較不同治療方案在肱骨髁部骨不連合并骨缺損患者中的應(yīng)用效果。方法選取2011年6月-2016年6月該院收治的62例肱骨髁部骨不連合并骨缺損患者為研究對象,采用隨機(jī)數(shù)表法將患者分為觀察組和對照組,各31例。對照組患者采用單純髂骨移植對骨缺損進(jìn)行重建,觀察組患者采用自體富血小板血漿聯(lián)合髂骨移植對骨缺損進(jìn)行重建。比較兩組患者的圍術(shù)期各時間、肘關(guān)節(jié)活動度、Cassebaum評分及并發(fā)癥發(fā)生率。結(jié)果觀察組與對照組手術(shù)時間、住院天數(shù)、骨性愈合時間及臨床愈合時間的比較,經(jīng)t檢驗(yàn),差異有統(tǒng)計(jì)學(xué)意義(P0.05),觀察組患者的手術(shù)時間、住院天數(shù)、骨性愈合時間及臨床愈合時間均低于對照組患者。治療前觀察組與對照組肘關(guān)節(jié)屈和伸活動度比較經(jīng)t檢驗(yàn)差異無統(tǒng)計(jì)學(xué)意義(t=1.835和1.915,P=0.075和0.067)。治療后觀察組與對照組肘關(guān)節(jié)屈和伸活動度比較經(jīng)t檢驗(yàn)差異有統(tǒng)計(jì)學(xué)意義(t=2.377和2.549,P=0.033和0.016),觀察組患者屈活動度高于對照組患者,伸活動度低于對照組患者。治療后觀察組優(yōu)良率80.63%,對照組優(yōu)良率77.41%,經(jīng)χ~2檢驗(yàn),差異無統(tǒng)計(jì)學(xué)意義(χ~2=1.653,P=0.081)。治療后,觀察組31例患者中1例延遲愈合,1例褥瘡,對照組31例患者中2例延遲愈合,2例褥瘡,2例深靜脈血栓,觀察組并發(fā)癥發(fā)生率6.45%(2/31),對照組患者的并發(fā)癥發(fā)生率19.35%(6/31),經(jīng)χ~2檢驗(yàn),差異有統(tǒng)計(jì)學(xué)意義(χ~2=6.035,P=0.030),對照組患者的并發(fā)癥發(fā)生率高于觀察組患者。結(jié)論給予肱骨髁部骨不連合并骨缺損患者自體富血小板血漿聯(lián)合髂骨移植治療較單純髂骨移植治療術(shù)后恢復(fù)快,修復(fù)效果好,可以在臨床上進(jìn)一步推廣和使用。
[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.
【作者單位】： 青海省人民醫(yī)院骨科;
【分類號】：R687.3

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