摘要
目的探讨体质量指数(BMI)对胫骨平台骨折切开复位内固定术后临床结局的影响。方法回顾性分析2015年6月—2017年6月南通大学附属东台医院骨科行切开复位内固定术治疗胫骨平台骨折患者88例,根据患者BMI将其分为三组,其中正常组(18.0≤BMI<24.0kg/m^(2))43例,男性24例,女性19例;年龄19~58岁,平均37.3岁;致伤原因道路交通伤27例,高处坠落伤12例,重物砸伤4例;超重组(24.0≤BMI<28.0kg/m^(2))25例,男性14例,女性11例;年龄20~62岁,平均38.6岁;致伤原因道路交通伤11例,高处坠落伤10例,重物砸伤4例;肥胖组(BMI≥28.0kg/m^(2))20例,男性12例,女性8例;年龄20~61岁,平均37.6岁;致伤原因道路交通伤10例,高处坠落伤8例,重物砸伤2例。患者均由同一组5年以上临床经验的医师行切开复位内固定术。比较三组疗效、膝关节功能、手术一般情况、术后3d平均体温、C-反应蛋白(CRP)恢复正常时间及并发症发生情况。结果正常组疗效有效率86%明显高于超重组的60%与肥胖组的50%,差异有统计学意义(χ^(2)=10.354,P=0.006),超重组与肥胖组比较差异无统计学意义(P>0.05)。三组患者手术时间、术中出血量、拆线时间、住院时间、3d平均体温、CRP恢复正常时间及膝关节功能方面比较差异均有统计学意义,正常组最少,其次为超重组,肥胖组最高(P<0.05)。三组患者术后并发症比较,肥胖组的切口感染率较正常组及超重组高,其他并发症三组比较差异无统计学意义(P>0.05)。结论BMI较高的患者胫骨平台骨折切开复位内固定术后疗效较差,且随BMI指数的升高患者手术一般情况及术后体温、CRP恢复正常时间、早期膝关节功能恢复均较差。
Objective To investigate the effect of body mass index(BMI)on the clinical outcome of tibial plateau fractures after open reduction and internal fixation.Methods From Jun.2015 to Jun.2017,88 patients with tibial plateau fractures were treated with open reduction and internal fixation at the Department of Orthopedics,Dongtai Hospital,Nantong University.They were divided into three groups according to their BMI.In the ideal group(18.0≤BMI<24.0kg/m^(2)),there were 43 cases,including 24 males and 19 females;their age ranged from 19 to 58 years,with an average of 37.3 years;and the cause of injury showed 27 cases of road traffic injuries,12 cases of falling injuries,and 4 cases of heavy objects injuries.In the overweight group,there were 25 cases(24.0≤BMI<28.0kg/m^(2)),including 14 males,11 females;their age ranged from 20 to 62 years,with an average of 38.6 years;and the cause of injury showed 11 cases of road traffic injuries,10 cases of falling injuries and 4 cases of heavy object injuries.In the obese group(BMI≥28.0kg/m^(2)),there were 20 cases,including 12 males and 8 females;their age ranged from 20 to 61 years,with an average of 37.6 years;and the causes of injury showed 10 cases of road traffic injuries,8 cases of injuries from falling from height,and 2 cases of injuries from heavy objects.The patients were all performed open reduction and internal fixation by the same group of physicians with more than 5 years of clinical experience.The curative effect,knee joint function,general operation condition,average body temperature of 3 days after operation,and time for CRP to return to normal were compared among the three groups.Results The effective rate of 86%in the ideal group was significantly higher than that of 60%in the overweight group and 50.00%in the obese group.The difference was statistically significant(χ^(2)=10.354,P=0.006).There was no significant difference between the overweight group and the obese group(P>0.05).There were statistically significant differences in duration of operation,intraoperative blood loss,duration of suture removal,duration of hospital stay,3-day average body temperature,CRP recovery time and knee joint function among the three groups.For complication rate,the ideal group was the lowest,followed by the overweight group,and the obese group was the highest(P<0.05).Conclusion Patients with high BMI have poorer efficacy after open reduction and internal fixation for tibial plateau fractures,and with the increase of BMI index,the general conditions of surgery,postoperative body temperature,CRP recovery time,and early knee function recovery are poorer.
作者
何洲
徐杨俊
郑卫平
周金军
周铭剑
侯刚
郭春
He Zhou;Xu Yangjun;Zheng Weiping;Zhou Jinjun;Zhou Mingjian;Hou Gang;Guo Chun(Department of Orthopaedics,Dongtai Hospital,Nantong University,Yancheng,Jiangsu 224200,China;Department of Orthopaedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221006,China)
出处
《创伤外科杂志》
2021年第3期205-208,共4页
Journal of Traumatic Surgery
基金
2017年江苏省卫生计生委医学科研课题(H201761)。
关键词
胫骨平台骨折
体质量指数
切开复位
内固定
膝关节功能
tibial plateau fracture
body mass index
open reduction
internal fixation
knee joint function
作者简介
通信作者:徐杨俊,E-mail:235646409@qq.com。
