| 引用本文:王宏1，陈杰2.应用克氏针内固定术及微型钢板内固定术联合赤参壮骨汤治疗手部骨折的病例分析[J].世界中医药,2018,(12):. |
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| 应用克氏针内固定术及微型钢板内固定术联合赤参壮骨汤治疗手部骨折的病例分析 |
| Case Analysis of Application of Kirschner's Needle Internal Fixation and Mini-plate Internal Fixation Combined with Chishen Zhuanggu Decoction in Treatment of Hand Fractures |
| 投稿时间：2018-08-07 |
| DOI：10.3969/j.issn.1673-7202.2018.12.015 |
| 中文关键词: 手部骨折 克氏针内固定术 微型钢板内固定术 赤参壮骨汤 疗效 |
| English Keywords:Hand fracture Kirschner's needle internal fixation Mini-plate internal fixation Chishen Zhuanggu decoction Curative effect |
| 基金项目:湖北省自然科学基金项目（2015CKC904） |
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| 中文摘要: |
| 目的：探讨应用克氏针内固定术及微型钢板内固定术联合赤参壮骨汤治疗手部骨折的临床疗效。方法：选取2010年1月至2017年8月铁煤集团总医院收治的手部骨折患者60例为研究对象，按照随机数字表法将其分为观察组与对照组，每组30例。对照组患者采用克氏针内固定术治疗，观察组采用微型钢板内固定术治疗；2组均于术后3 d给予赤参壮骨汤治疗，连续应用2个月，并于术后定期随访6个月。比较2组治疗后手部功能恢复情况、临床指标骨代谢情况；统计随访过程中2组骨折愈合情况。结果：治疗后观察组与对照组手部功能优良率分别为90.00%、66.67%，观察组手部功能优良率显著高于对照组（P<0.05）。观察组手术时间长于对照组，总主动屈曲度高于对照组，骨折愈合时间及住院时间短于对照组（P<0.01）。治疗后2组血清BGP、OPG、BMP2、IGF-Ⅰ等指标水平均较治疗前显著升高（均P<0.01），但2组间上述指标差异无统计学意义（P>0.05）。随访过程中观察组骨折延迟愈合及感染的发生率显著低于对照组（P<0.05）。结论：与克氏针内固定术术比较，微型钢板内固定术治疗手部骨折的临床疗效更加良好，对手部功能的干扰更小；在手术的基础上联合赤参壮骨汤可显著提升患者骨形成指标水平，有利于骨折的康复。 |
| English Summary: |
| To investigate the effect of kirschner's needle internal fixation and mini-plate internal fixation combined with Chishen Zhuanggu decoction in the treatment of hand fracture.Methods:A total of 60 cases of patients with hand fracture,who was treated in Hospital of Tiefa Energy from January 2010 to January 2018,were selected,and were divided into observation group and control group by random digital table method.Each group had 30 cases.The control group was given kirschner's needle internal fixation,and the observation group was treated with mini-plate internal fixation.Both groups were treated with Chishen Zhuanggu decoction 3 days after operation,which was applied continuously for 2 months.The patients were regularly followed-up for 6 months after operation.A comparison was made between the 2 groups of hand function recovery,clinical indexes and bone metabolism after treatment.The conditions of fracture healing between 2 groups during following-up were recorded.Results:After treatment,the good rate of hand function of observation group and control group were 90.00% and 66.67% respectively,the good rate of hand function in observation group was significantly higher than that of control group (P<0.05).The operation time of observation group was longer than that of control group,the total active flexion degree of observation group was higher than that of control group,and the fracture healing time and hospitalization time were shorter than those of control group (P<0.01).The serum levels of BGP,OPG,BMP2 and IGF-I in 2 groups were significantly higher than those before treatment (P<0.01),but there was no significant difference between 2 groups after treatment (P>0.05).The incidence of delayed union and infection in observation group were significantly lower than those in control group during following-up (P<0.05).Conclusion:Compared with krschner wire internal fixation,mini-plate internal fixation is more effective in the treatment of hand fracture and has less interference to hand function.Combined with Chishen Zhuanggu decoction on the basis of fixation,it can significantly improve the fracture healing status of patients,which is worthy of clinical application. |
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