【摘要】 目的探讨微创治疗创伤性肘关节僵硬(TES)及对肘关节功能、血清学指标的影响。方法选取2015年1月至2019年12月我院收治的TES患者116例,按照随机数字表法分为微创组与对照组各58例。对照组行开放松解术,微创组行微创松解术。比较两组切口长度、术中出血量及手术时间等围术期指标;术前及术后6个月肘关节活动度及Mayo评分;术前及术后3 d血清内啡肽(β-EP)、神经肽Y(NPY)、P物质(SP)等疼痛因子,血清丙二醛(MDA)、谷胱甘肽过氧化物酶(GSHPx)、脂质过氧化物(LPO)、超氧化物歧化酶(SOD)等氧化应激因子;两组术后并发症。结果微创组切口长度、术中出血量及手术时间等围术期指标均小于对照组(P<0.05);术后6个月,两组伸直、屈曲、内旋、外旋活动度及Mayo评分比较,差异均无统计学意义(P>0.05);术后3 d,微创组血清β-EP、NPY、SP及SOD、GSH-Px水平低于对照组,LPO、MDA水平高于对照组(P<0.05);微创组术后并发症发病率低于对照组(P<0.05)。结论微创松解术治疗TES不但可获得与开放松解术一致的手术效果,还可有效避免机体过度损伤及氧化应激,抑制疼痛因子生成,降低术后并发症发生率。更多还原

【Abstract】 Objective To explore the clinical efficacy of minimally invasive release operation in the treatment of traumatic elbow stiffness( TES) and its influence on function of elbow and serum indexes.Methods A total of 116 TES patients in our hospital from January 2015 to December 2019 were involved in this study.The patients were divided into minimally invasive group and control group using the random number table method,87 in each group. Open release operation was performed in the control group,and minimally invasive release operation was performed in the minimally invasive group. Perioperative indicators such as incision length,intraoperative blood loss and operative time were compared between the two groups. Joint mobility of elbow and Mayo score before operation and after 6 months of operation were recorded. The levels of pain factor such as serum endorphin( β-EP),neuropeptide Y( NPY) and substance P( SP) were compared between the two groups before operation and 3 days after operation. The levels of oxidative stress factors such as serum malondialdehyde( MDA),glutathion peroxidase( GSH-Px),lipid peroxide( LPO),and superoxide dismutase( SOD) were compared between the two groups before operation and 3 days after operation. Postoperative complications were also compared between the two groups. Results The incision length,intraoperative blood loss and operative time in the minimally invasive group were lower or shorter than those in the control group( P<0. 05). After 6 months of operation,there were no difference in unbend,flexion,internal rotation,external rotation and Mayo score between the two groups( P>0. 05). After 3 days of operation,levels of serumβ-EP,NPY,SP,SOD and GSH-Px in the minimally invasive group were lower than those in the control group.The levels of serum LPO,and MDA in the minimally invasive group were higher than those in the control group( P<0. 05).The incidence of postoperative complications in the minimally invasive group was lower than that in the control group( P< 0. 05). Conclusion Minimally invasive release operation for TES can not only achieve the same surgical effect as open release operation,but also effectively avoid excessive injury and oxidative stress,inhibit the generation of pain factors,and reduce the incidence of postoperative complications.更多还原