扩髓髓内钉与锁定接骨板治疗股骨干骨折的临床对比研究-外科学(骨外科)专业论文.docxVIP

汕头大 汕头大学医学院硕士毕业论文 I II 发表论文情况………………………………………………………………………………31 个人简历……………………………………………………………………………………36 PAGE PAGE IV 中文摘要 目 的 ： 观 察 股 骨 扩 髓 髓 内 钉 (reamed intramedullary nail, RIN) 和 锁 定 接 骨 板 (locking compression plate, LCP)治疗股骨干骨折患者的临床疗效并进行对比分析。 方法：回顾性分析 2009 年 8 月至 2011 年 12 月期间，我院采用 RIN 和 LCP 内固定治疗 且随访时间超过 10 个月的股骨干骨折患者，其中采用 RIN 内固定治疗者 25 例，采用 LCP 内固定治疗者 25 例。所有患者术后 6h 开始不负重状态下功能锻炼。对比分析两组患者手 术时间、术中失血量、伤口长度、住院时间、术后 SIRS 发生率、术后 8 周骨痂面积、Flynn 功能预后评价等情况。 结果：所有患者均获得随访，平均 17.1±5.64 个月。两组术中出血量、住院时间、术后 SIRS 发生率、Flynn 功能预后评价等之间的差异均无统计学意义。RIN 组手术时间较 LCP 组长，伤口长度较 LCP 组短，术后第 8 周 RIN 组骨痂面积比 LCP 组大，差异均有统计学 意义（P0.05）。 结论：扩髓髓内钉与锁定接骨板两组内固定方式治疗股骨干骨折均能取得良好的治疗效 果，但扩髓髓内钉术后骨痂形成较多，骨折愈合情况更为理想。 关键词：股骨干骨折；内固定；扩髓髓内钉；锁定接骨板 ABSTRACT Objective: To observe and compare the clinical outcome of reamed intramedullary nail (RIN) and locking compression plate (LCP) in femoral shaft fracture. Methods: From August 2009 to December 2011, a retrospective study of femoral shaft fracture patients who had been treated with RIN or LCP and also followed up for more than 10 months was carried out, including 25 cases with RIN and 25 cases with LCP. All these patients had started functional training at 6 hours after surgery. We compared operation time, volume of intraopetative bleeding, length of cut, hospitalization, occurrence rate of SIRS, area of callus in 8 weeks after surgery, postoperative complications and functional recovery of two groups. Results: The average follow-up period was 17.1 ± 5.64 months. There were no significant differences between two groups in volume of intraopetative bleeding, hospitalization, occurrence rate of SIRS and Flynn’s outcome scoring. The operation time and area of callus in RIN group was more than LCP group. The length of cut in RIN group was shorter than LCP group. The differences were statistical significance（P0.05）. Conclusion: Although both RIN and LCP yield good result and minimal complication in femoral shaft fracture. RIN may be advantageous in gaining callus and h