摘要【目的】比较经皮微创接骨板内固定术(MIPPO)与切开复位内固定术(ORIF)对A型老年胫骨远端骨折患者的治疗效果。【方法】选取2018年6月至2020年3月在山东省立第三医院收治的84例老年A型胫骨远端骨折患者为研究对象,依据患者所选手术的类型分为MIPPO组(MIPPO治疗,42例)和ORIF组(ORIF治疗,42例)。比较两组患者手术时间、术中出血量、伤口愈合时间、骨折愈合时间及患者术前与术后24 h血清炎性因子水平和术后6个月临床疗效。随访12个月,统计两组患者并发症发生情况。【结果】MIPPO组患者手术时间、伤口愈合时间及骨折愈合时间均短于ORIF组(P<0.05),术中出血量低于ORIF组(P<0.05)。术后24 h两组患者C反应蛋白(CRP)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)均高于术前(P<0.05),MIPPO组术后24 h CRP、IL-1及IL-6均低于ORIF组(P<0.05)。术后6个月,MIPPO组患者优良率高于ORIF组(92.86% vs 76.19%,χ2=4.459,P<0.05)。MIPPO组术后并发症总发生率低于ORIF组(4.76% vs 19.04%,χ2=4.086,P<0.05)。【结论】相比ORIF,MIPPO治疗A型老年胫骨远端骨折患者可缩短手术时间、伤口愈合及骨折愈合时间、减少术中出血量,减轻炎症反应,提高临床治疗效果,降低术后并发症的发生率。
Abstract：【Objective】To compare the therapeutic effects of percutaneous minimally invasive plate internal fixation (MIPPO) and open reduction and internal fixation (ORIF) on type A elderly patients with distal tibial fractures. 【Methods】 A total of 84 elderly patients with type A distal tibial fracture treated in our hospital from June 2018 to March 2020 were selected as the research objects. According to the type of operation selected, the patients were divided into MIPPO group (MIPPO treatment, 42 cases) and ORIF group (ORIF treatment, 42 cases). The operation time, intraoperative bleeding, wound healing time, fracture healing time, serum inflammatory factor level before and 24 hours after operation and clinical curative effect 6 months after operation were compared between the two groups. The patients were followed up for 12 months. 【Results】The operation time, wound healing time and fracture healing time in the MIPPO group were shorter than those in the ORIF group (P<0.05), and the intraoperative blood output was lower than that in the ORIF group (P<0.05). At 24 hours after operation, the levels of C-reactive protein (CRP), interleukin-1 (IL-1) and interleukin-6 (IL-6) in the two groups were higher than those before operation (P<0.05). At 24 hours after operation, CRP, IL-1 and IL-6 in the MIPPO group were lower than those in the ORIF group (P<0.05). Six months after operation, the excellent and good rate in the MIPPO group was higher than that in the ORIF group (92.86% vs 76.19%,χ2=4.459, P<0.05). The total incidence of postoperative complications in the MIPPO group was lower than that in the ORIF group (4.76% vs 19.04%,χ2=4.086, P<0.05). 【Conclusion】 Compared with ORIF, MIPPO can shorten the operation time, wound healing and fracture healing time, reduce the amount of intraoperative bleeding, reduce the inflammatory reaction, improve the clinical treatment effect and reduce the incidence of postoperative complications.
郑晓林, 高强, 李园园. MIPPO与ORIF治疗A型老年胫骨远端骨折的疗效比较[J]. 医学临床研究, 2021, 38(11): 1670-1673.
ZHENG Xiao-lin, GAO Qiang, LI Yuan-yuan. Comparison of MIPPO and ORIF in the Treatment of Type A Elderly Distal Tibial Fractures. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1670-1673.
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2021, Vol. 38 
