摘要
目的比较Tube通道微创手术与传统开放手术治疗股骨干骨不连的临床疗效。方法回顾性分析2016-03至2018-06解放军总医院第一医学中心收治的股骨干骨折术后非感染性骨不连患者临床资料(29例),其中采用Tube通道微创手术13例(Tube通道组),传统开放手术16例(开放组),根据Tohner-Wrnch标准评定骨折愈合情况和SF-36评分评价术后功能。结果两组患者在年龄、性别、骨不连类型、骨不连时间、随访时间等基础信息方面均无统计学差异。Tube通道组切口[(6.38±1.45)cm]明显小于开放组[(20.56±7.69)cm],差异有统计学意义(P=0.003);开放组手术时间[(250.75±53.82)min]和术中出血量[(565.63±239.94)ml]均显著多于Tube通道组手术时间[(116.15±23.29)min]和术中出血量[(105.00±15.00)ml],差异有统计学意义(P<0.05)。末次随访时两组患者评价均为愈合,优良率均为100%。SF-36生理功能评分和躯体疼痛评分两组间比较差异均无统计学意义。结论Tube通道微创技术操作相对简便、手术时间短、术中出血少、手术创伤小、临床疗效满意,是一种较理想的治疗方法。
Objective To compare the clinical efficacy of minimally invasive tube channel technique and traditional open technique in the treatment of femoral shaft nonunion.Methods Between March 2016 and June 2018,a total of 29 patients with femoral shaft nonunion were included into this study.Thirteen of these patients underwent minimally invasive surgery via the tube channel(tube channel group),while another 16 patients received traditional open surgery(open group).The healing of femoral shaft nonunion was evaluated based on the Tohner-Wrnch criteria and the postoperative function was evaluated according to SF-36 scores.Results There was no significant difference in age,gender,bone nonunion types,duration of bone nonunion or length of follow-up between the two groups.The incisions in the tube channel group[(6.38±1.45)cm]were significantly smaller than those in the open group[(20.56±7.69)cm,P=0.003].The duration of surgery[(116.15±23.29)min vs.(250.75±53.82)min]and intra-operative blood loss[(105.00±15.00)ml vs.(565.63±239.94)ml]were significantly shorter or less in the tube channel group(P<0.05).The femoral shaft nonunion was healed and the excellent and good rate of clinical outcomes was 100%in both groups during the last follow-up.There was no significant difference in SF-36 physical function scores or bodily pain scores between the two groups.Conclusions The minimally invasive tube channel technique has the advantages of easy operation,shorter duration of surgery,decreased blood loss,and reduced iatrogenic damage,which is an ideal treatment.
作者
石斌
杜海龙
罗杨
张巍
张立海
SHI Bin;DU Hailong;LUO Yang;ZHANG Wei;ZHANG Lihai(Department of Orthopedics,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)
出处
《武警医学》
CAS
2021年第7期585-589,共5页
Medical Journal of the Chinese People's Armed Police Force
基金
国家重点研发计划(2020YFC2004902)
