论文部分内容阅读
目的:探讨改良透视方法在肱骨近端骨折内固定术中应用可行性。方法:前瞻性研究。纳入2017年6月—2019年12月西安市中心医院骨二科单纯肱骨近端骨折患者36例，其中男12例、女24例，年龄61～79岁。骨折按Neer分型，3部分骨折25例，4部分骨折11例。按随机数字表法分为对照组和观察组，每组18例。两组患者均采用胸大肌三角肌间隙入路行切开复位钢板内固定手术治疗，其中对照组术中采用传统X线透视法，观察组采用改良X线透视方法。对比两组患者临床基线资料，术中最后一轮正侧位X线透视所需要的次数和时间，比较两组的手术时间、术中出血量、术后并发症发生情况。术后12个月，对比两组患者骨折愈合时间及肩关节功能Neer评分情况。结果:两组患者性别、年龄、骨折Neer分型等临床基线资料比较，差异均无统计学意义(n P值均>0.05)。对照组最后一轮透视所需次数3～7(4.2±1.2)次、累计时间3.5～15(5.6±2.6)min，观察组最后一轮X线透视所需透视次数2～5(2.5±0.9)次、累计时间2.5～6.5(3.1±1.0)min，差异均有统计学意义(n t＝4.808、3.808, n P值均0.05). In the control group, the number of fluoroscopy required for the last round was three to seven times (4.2±1.2) and the cumulative time was 3.5-15.0 min (5.6±2.6). In the observation group, the number of X-ray fluoroscopy required for the last round was two to five times (2.5±0.9), and the cumulative time was 2.5-6.5 (3.1±1.0) min; the differences were statistically significant (n t= 4.808, 3.808, all n P values<0.01). The operative time and intraoperative blood loss of the observation group were 77 ±5 min and (84±5) mL, respectively. All values were lower than (85±6) min and ( 94±8) mL in the control group, and the differences were statistically significant (n t=4.335, 4.384, all n P values0.05). On the basis of the Neer score criterion of shoulder joint, 7 cases were excellent, 6 cases were good, and 1 case was fair in the observation group, whereas 6 cases were excellent, 6 cases were good, and 1 case was fair in the control group.n Conclusions:The modified intraoperative X-ray fluoroscopy method can reduce the radiation exposure of the surgeon and the patient compared with traditional fluoroscopy. This method is worthy of being recommended in clinical settings because it is reproducible and easy to implement and indirectly shortens the operative time to decrease bleeding during operation and the risk of postoperative incision infection.