锁定钢板内固定联合玻璃酸钠对胫骨平台骨折术后膝关节功能及综合应激状态的影响

目的探讨锁定钢板内固定联合玻璃酸钠对胫骨平台骨折术后膝关节功能及综合应激状态的影响。方法选取100例胫骨平台骨折病人为研究对象，随机分为对照组和观察组，各50例；对照组给予锁定钢板内固定手术，观察组给予锁定钢板内固定联合玻璃酸钠方式，检测病人的膝关节功能及综合应激状态水平。结果观察组病人的拆线后负重时间、愈合时间均明显短于对照组（P < 0.01）。2组病人术后第1周、2周、4周的膝关节活动度及Rasmussen评分逐渐升高（P < 0.01），且观察组明显高于对照组（P < 0.01）。2组病人术后1 d、3 d及7 d的膝疼痛VAS评分逐渐降低，且观察组术后3 d、7 d明显低于对照组（P < 0.01）。2组病人术后1 d、3 d及7 d神经肽Y、前列腺素2、P物质、白细胞介素1β、肿瘤坏死因子-α、C反应蛋白水平逐渐降低（P < 0.01），且观察组明显低于对照组（P < 0.01）。术后1 d 2组过氧化氢酶、过氧化物歧化酶差异有统计学意义（P < 0.01和P < 0.05），术后3 d及7 d 2组过氧化氢酶、总抗氧化能力、超氧化物歧化酶水平差异均有统计学意义（P < 0.01）。结论锁定钢板内固定联合玻璃酸钠治疗胫骨平台骨折，能够减轻病人膝疼痛，减轻病人的应激反应，促进膝关节功能恢复，值得临床推广。

Effect of locking plate internal fixation combined with sodium hyaluronate on postoperative knee function and comprehensive stress of tibial plateau fracture

ObjectiveTo explore the effects of locking plate internal fixation combined with sodium hyaluronate on postoperative knee function and comprehensive stress of tibial plateau fracture.MethodsOne hundred cases with tibial plateau fracture were randomly divided into the observation group and control group(50 cases in each group).The control group was treated with locking plate internal fixation, and the observation group was treated with locking plate internal fixation combined with sodium hyaluronate.The knee function and comprehensive stress in two groups were evaluated.ResultsThe weight bearing time and healing time in observation group after stitch were significantly shorter than those in control group(P < 0.01).After 1, 2, 4 weeks of operation, the knee mobility and Rasmussen score in two groups gradually increased, and which in observation group was significantly higher than that in control group(P < 0.01).At postoperative 1, 3 and 7 days, the VAS scores of knee pain in two groups reduced gradually, and which in observation group after 3 and 7 days were significantly lower than that in control group(P < 0.01).At postoperative 1, 3 and 7 days, the expression levels of pain stress(NPY, PGE2 and SP), inflammatory stress(IL-1β, TNF-α and CRP) in two groups reduced gradually, and which in observation group was significantly lower than that in control group(P < 0.01).The differences of the levels of CAT and SOD after 1 day of operation between two groups were statistically significant(P < 0.01 and P < 0.05), and the difference of the levels of CAT, total antioxidant capacity and SOD after 3 and 7 days of operation between two groups were statistically significant(P < 0.01).ConclusionsLocking plate internal fixation combined with sodium hyaluronate treating tibial plateau fracture can reduce the knee pain and stress response and promote the knee function recovery, which is worthy of clinical application.