【摘要】：目的：評估非手術(shù)(手法復(fù)位杉樹皮夾板外固定配合中藥三期用藥及功能鍛煉)治療肱骨近端骨質(zhì)疏松性骨折的臨床療效。方法：通過總結(jié)分析自2008年7月-2013年12月間浙江省拱墅區(qū)人民醫(yī)院外科收治的臨床診斷為肱骨近端骨質(zhì)疏松性骨折符合納入標(biāo)準(zhǔn)且均獲完整隨訪的60例病例。本研究所納入的病例中男性22例,女性38例,年齡最大94歲,最小63歲,平均年齡78歲。根據(jù)其治療方法的不同,將其分為兩組：A組30例手法整復(fù)、杉樹皮夾板外固定配合中藥三期用藥；B組30例手法整復(fù)、石膏外固定配合中藥三期用藥：觀察治療后第4周,第8周,第24周的肩關(guān)節(jié)功能恢復(fù)情況(采用Neer百分制評分對肩關(guān)節(jié)功能評分)。并采用Spss satistics 19.0軟件進行分析。結(jié)果： 兩種治療方法患者的基線資料, 經(jīng)統(tǒng)計學(xué)檢驗, 差異無顯著性(P0.05)。兩種治療方法在第4周時,解剖評分、疼痛評分、活動范圍及功能評分均差異無顯著性(P0.05) ；第8周時,解剖評分、疼痛評分差異無顯著性(P0.05),活動范圍及功能評分差異有顯著性(P0.05) ；第24周時,解剖評分、疼痛評分及活動范圍差異無顯著性(P0.05),功能評分差異有顯著性(P0.05)A組優(yōu)良率90.0%優(yōu)10例、良17例、中2例、差1例；B組優(yōu)良率86.7%優(yōu)9例、良17例、中2例、差2例。結(jié)論：杉樹皮夾板固定和石膏固定肱骨近端骨質(zhì)疏松性骨折的療效對比,在解剖評分、疼痛評分上無明顯差別,在功能評分及活動范圍上杉樹皮夾板固定優(yōu)于石膏固定。對于肱骨近端骨質(zhì)疏松性骨折總體療效杉樹皮夾板固定優(yōu)于石膏固定。杉樹皮夾板外固定符合現(xiàn)代骨科倡導(dǎo)的生物力學(xué)觀點,能有效防止應(yīng)力遮擋,并且據(jù)有操作簡單、創(chuàng)傷小、并發(fā)癥少、費用低、減輕患者經(jīng)濟負擔(dān)的優(yōu)點,是一種可靠的治療方法,在臨床上有一定推廣價值。
[Abstract]:Objective: to evaluate the clinical effect of non-operative treatment of osteoporotic fracture of proximal humerus. Methods: from July 2008 to December 2013, 60 cases of osteoporotic fracture of proximal humerus which were diagnosed as osteoporotic fracture of proximal humerus were reviewed and analyzed. There were 22 males and 38 females, aged 94 and 63 years, with an average age of 78 years. According to the different treatment methods, the patients were divided into two groups: 30 cases in group A, 30 cases in group B, 30 cases in group B, and 3 cases in group B: observe the 4th week after treatment. The recovery of shoulder function was observed at the 8th week and the 24th week (using the Neer percentile score). The software Spss satistics 19.0 was used to analyze. Results: there was no significant difference in baseline data between the two treatments (P0.05). There was no significant difference in anatomic score, pain score, range of activity and functional score between the two treatments at the 4th week (P0.05), while at the 8th week, the anatomic score was not significantly different from that of the control group. There was no significant difference in pain score (P0.05), but there was significant difference in activity range and function score (P0.05); at the 24th week, there was no significant difference in anatomical score, pain score and range of activity (P0.05), and there was significant difference in functional score (P0.05). The excellent and good rate was 86.7% in group B, good in 17 cases, fair in 2 cases and poor in 2 cases. Conclusion: there is no significant difference in anatomical score and pain score between fir splint fixation and plaster fixation for proximal humerus osteoporotic fracture, but in function score and activity range, fir bark splint fixation is superior to plaster fixation. General effect on osteoporotic fracture of proximal humerus the fixation of Chinese fir skin splint is superior to plaster fixation. The external fixation of Chinese fir bark splint accords with the biomechanical viewpoint advocated by modern orthopedic department, and it can effectively prevent stress occlusion, and has the advantages of simple operation, less trauma, less complications, low cost and lightening the economic burden of patients. It is a kind of reliable treatment method, and has certain popularizing value in clinic.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

【參考文獻】

相關(guān)期刊論文 前10條

1 付中國;鄧?yán)?白露;陳建海;張培訓(xùn);黨育;張殿英;姜保國;;肱骨近端骨折鎖定接骨板治療術(shù)后并發(fā)癥分析[J];北京大學(xué)學(xué)報(醫(yī)學(xué)版);2011年05期

2 蘭彬;;外展架在肱骨外科頸骨折保守治療中的應(yīng)用[J];臨床醫(yī)學(xué);2008年10期

3 張恒;李文銳;;影響骨折愈合的因素——應(yīng)力和微動[J];海南醫(yī)學(xué);2010年01期

4 馮清和;陳緒文;黃大社;;皮牽甩肩法治療老年肱骨外科頸骨折56例臨床分析[J];中外醫(yī)療;2008年21期

5 付寶光;;肱骨外科頸骨折手術(shù)治療體會[J];中外醫(yī)療;2009年09期

6 黎旭軍;;皮牽甩肩法并夾板固定治療肱骨近端粉碎性骨折46例[J];江西中醫(yī)藥;2007年01期

7 李營;黃霖;黃建榮;李衛(wèi)平;;微創(chuàng)穿針固定法治療肱骨外科頸骨折[J];嶺南現(xiàn)代臨床外科;2006年02期

8 湯劍斌;樊天佑;;肱骨近端粉碎骨折鎖定鋼板與人工肱骨頭置換術(shù)的對比研究[J];實用骨科雜志;2012年01期

9 李洪,任紅波;張力帶內(nèi)固定治療老年肱骨外科頸粉碎性骨折[J];實用醫(yī)技雜志;2004年02期

10 張翠文;李至紅;;骨折治療中動靜結(jié)合的治療方法分析[J];醫(yī)學(xué)信息(中旬刊);2010年10期

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