杨宏志　胡斌　王溪淳　陈文杰

【摘要】 目的：分析微創经皮接骨板内固定术治疗胫骨平台骨折患者的效果及对Lysholm膝关节评分的影响。方法：回顾性分析2018年1月-2020年12月本院收治的80例胫骨平台骨折患者的临床资料，根据治疗方法将其分为研究组和对照组，每组40例。对照组实施传统切开复位内固定，研究组实施微创经皮接骨板内固定术。比较两组相关临床指标、不良事件发生情况、术前及术后3 d的炎症因子（CRP、IL-1β、IL-8）和术前与术后3个月的膝关节功能（Lysholm评分）、生活质量（SF-36评分）。结果：两组手术时间比较，差异无统计学意义（P>0.05）;研究组术中出血量、术后引流量均少于对照组，切口长度、术后住院时间、骨折愈合时间均短于对照组，差异均有统计学意义（P<0.05）。术前，两组CRP、IL-1β、IL-8比较，差异均无统计学意义（P>0.05）;术后3 d，两组CRP、IL-1β、IL-8均高于术前，但研究组均低于对照组，差异均有统计学意义（P<0.05）。术前，两组Lysholm、SF-36各维度评分比较，差异均无统计学意义（P>0.05）;术后3个月，两组Lysholm、SF-36各维度评分均高于术前，且研究组均高于对照组，差异均有统计学意义（P<0.05）。研究组不良事件发生率为10.00%，低于对照组的32.50%，差异有统计学意义（P<0.05）。结论：微创经皮接骨板内固定术治疗胫骨平台骨折的效果较好，可有效促进患者的术后恢复，改善其术后膝关节功能及生活质量，临床应用价值较高。

【关键词】 微创经皮接骨板内固定术 胫骨平台骨折 Lysholm评分

The Effect of Minimally Invasive Percutaneous Plate Osteosythesis in Patients with Tibial Plateau Fractures and Its Effect on the Lysholm Knee Scores/YANG Hongzhi， HU Bin， WANG Xichun， CHEN Wenjie. //Medical Innovation of China， 2021， 18（23）： 0-076

[Abstract] Objective： To analyze the effect of minimally invasive percutaneous plate osteosythesis in patients with tibial plateau fractures and its influence on the Lysholm knee scores. Method： The clinical data of 80 patients with tibial plateau fracture admitted to our hospital from January 2018 to December 2020 were retrospectively analyzed， and they were divided into study group and control group according to the treatment method， 40 cases in each group. The control group was treated with traditional open reduction and internal fixation， and the study group was treated with minimally invasive percutaneous plate osteosythesis. The clinical indicators， adverse events were compared between two groups， the inflammatory factors （CRP， IL-1β， IL-8） before and 3 d after surgery were compared between two groups， the knee function （Lysholm scores） and quality of life （SF-36 scores） before and 3 months after surgery were compared between two groups. Result： There was no significant difference in surgical time between two groups （P>0.05）; the intraoperative blood loss and postoperative drainage of the study group were lower than those of the control group， and the incision length， postoperative hospital stay and fracture healing time were shorter than those of the control group， the differences were statistically significant （P<0.05）. Before surgery， there were no significant differences in CRP， IL-1β and IL-8 between two groups （P>0.05）; 3 d after surgery， the CRP， IL-1β and IL-8 of two groups were higher than those before surgery， and those of the study group were lower than those of the control group， the differences were statistically significant （P<0.05）. Before surgery， there were no significant differences in Lysholm and SF-36 scores in all dimensions between two groups （P>0.05）; 3 months after surgery， Lysholm and SF-36 scores in all dimensions of both groups were higher than those before surgery， and those of the study group were higher than those of the control group， the differences were statistically significant （P<0.05）. The incidence of adverse events of the study group was 10.00%， lower than 32.50% of the control group， the difference was statistically significant （P<0.05）. Conclusion： The minimally invasive percutaneous plate osteosythesis is effective in the treatment of tibial plateau fractures， it can promote the postoperative recovery of patients and improve their postoperative knee joint function and quality of life， it has high clinical application value.

[Key words] Minimally invasive percutaneous plate osteosythesis Tibial plateau fractures Lysholm score

First-author’s address： Jiujiang First People’s Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.23.018

胫骨平台骨折是一种较为常见的骨折类型，多数患者伴有不同程度关节面压缩及移位、附近软组织损伤，受伤原因包括交通事故、高处坠落等，若不能正确处理，则很有可能影响患者的膝关节功能，严重降低其生活质量[1-3]。……