| 阮原芳.肩胛骨A3型骨折患者采用外侧缘入路和后方Judet入路治疗效果对比[J].实用中西医结合临床,2022,22(22): |
| 肩胛骨A3型骨折患者采用外侧缘入路和后方Judet入路治疗效果对比 |
| Comparison of therapeutic effects of lateral margin approach and posterior Judet approach in patients with A3 type scapular fractures |
| 投稿时间：2022-11-14 修订日期：2022-11-21 |
| DOI： |
| 中文关键词: 肩胛骨A3型骨折 入路 术后并发症 骨骼生长因子 肩关节功能 |
| 英文关键词: Type A3 fracture of scapula Approach Postoperative complications Bone growth factor Shoulder joint function |
| 基金项目: |
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| 中文摘要: |
| 目的：探究肩胛骨A3型骨折患者采用外侧缘入路和后方Judet入路治疗效果对比。方法：病历选取时间为2016年-2022年，选取该时间段内收治肩胛骨A3型骨折患者48名，根据外侧缘入路和后方Judet入路治疗进行分组，外侧缘入路为观察组，后方Judet入路为对照组，各24例。术后观察疗效，包括手术切口长度、手术时间、术中出血量、术后切口愈合时间、血清实验室指标水平（骨骼生长因子/SGF、骨碱性磷酸酶/BAP、骨形态发生蛋白/BMP）、术后并发症（切口感染、神经损伤、软组织挛缩）、术后Hardegger评分功能评定优良率、肩关节功能（Constant-Murley）评分、生活活动能力（Barthel）评分、疼痛（VAS）评分、舒适度（Kolcaba）评分变化。结果：观察组手术切口长度、术中出血量低于对照组（P＜0.05），手术时间、术后切口愈合时间短于对照组（P＜0.05）。术前，两组SGF、BAP、BMP等血清指标对比无差异（P＞0.05）。术后随访，观察组SGF、BMP等均优于对照组（P＜0.05）。两组术后BAP指标对比无差异（P＞0.05）。观察组术后并发症发生率低于对照组（P＜0.05）。观察组术后Hardegger评分功能评定优良率高于对照组（P＜0.05）。术前，两组患者Constant-Murley评分、Barthel评分、VAS评分、Kolcaba评分对比无差异（P＞0.05）。术后随访，观察组各评分均优于对照组（P＜0.05）。结论：肩胛骨A3型骨折患者采用外侧缘入路治疗效果优于后方Judet入路治疗，可有效缩短患者康复时间，术后并发症风险较低，预后显著，建议推广。 |
| 英文摘要: |
| Objective: To compare the therapeutic effect of lateral margin approach and posterior Judet approach in patients with type A3 scapular fracture. Methods: The medical record was selected from 2016 to 2022. Forty eight patients with A3 type scapular fractures were selected during this period. They were divided into two groups according to the lateral margin approach and the posterior Judet approach. The lateral margin approach was the observation group, and the posterior Judet approach was the control group, with 24 patients in each group. Postoperative observation of the efficacy, including the length of the surgical incision, the operation time, the amount of intraoperative bleeding, the time of wound healing, the level of serum laboratory indicators (bone growth factor/SGF, bone alkaline phosphatase/BAP, bone morphogenetic protein/BMP), postoperative complications (wound infection, nerve injury, soft tissue contracture), the excellent and good rate of post-operative Hardegger score function evaluation, the Constant Murley score Changes in Barthel score, VAS score and Kolcaba score.Results:The length of surgical incision and intraoperative blood flow in the observation group were lower than those in the control group (P. Before operation, there was no difference in serum indexes such as SGF, BAP and BMP between the two groups (P>0.05). After follow-up, SGF and BMP in the observation group were better than those in the control group (P<0.05). There was no difference in BAP between the two groups (P>0.05). The incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05). The excellent and good rate of Hardegger scoring function in the observation group was higher than that in the control group (P<0.05). Before operation, there was no difference between the two groups in Constant Murley score, Barthel score, VAS score and Kolcaba score (P>0.05). All scores in the observation group were better than those in the control group (P<0.05).Conclusion: The lateral margin approach is superior to the posterior Judet approach in the treatment of A3 type scapular fractures, which can effectively shorten the recovery time of patients, reduce the risk of postoperative complications, and have a significant prognosis. It is recommended to popularize. |
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