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闭合复位髓内钉固定治疗股骨干骨折对VEGF、HIF-1α表达的影响
作者:金培程1  程正江2 
单位:1. 湖北医药学院附属襄阳市第一人民医院 骨科, 湖北 襄阳 441000;
2. 襄阳市中心医院 骨科, 湖北 襄阳 441000
关键词:髓内钉 股骨干骨折 血管内皮生长因子 低氧诱导因-1α 
分类号:R683.42
出版年·卷·期(页码):2020·39·第二期(201-206)
摘要:

目的: 探讨闭合复位髓内钉固定治疗股骨干骨折对血管内皮生长因子(VEGF)、低氧诱导因-1α(HIF-1α)表达的影响。方法: 采用随机抽样与回顾性研究法,研究时间为2014年2月~2017年5月,选择在我院诊治的股骨干骨折成人患者78例作为研究对象,根据治疗方法的不同分为观察组40例与对照组38例,观察组给予闭合复位髓内钉固定治疗,对照组给予钢板内固定治疗,记录VEGF、HIF-1α表达变化情况。结果: 观察组的骨折愈合时间、术后住院天数、术中出血量、手术时间少于对照组(P<0.05)。观察组与对照组术后1个月的髋内翻、静脉血栓形成、骨髓炎、切口感染等并发症发生率分别为5.0%和28.9%(P<0.05)。观察组与对照组术后3个月的膝关节优良率分别为95.0%和73.7%(P<0.05)。两组术后3个月的血清VEGF、HIF-1α水平高于术前1 d(P<0.05),观察组高于对照组,对比差异都有统计学意义(P<0.05)。结论: 闭合复位髓内钉固定治疗股骨干骨折能促进VEGF、HIF-1α的表达,减少并发症的发生,减少对于患者的创伤,改善患者的膝关节功能。

Objective: To investigate the effects of closed reduction intramedullary nailing on the expression of vascular endothelial growth factor (VEGF) and hypoxia induced -1ɑ(HIF-1ɑ) in femoral shaft fracture. Methods: Using random sampling and retrospective study, from February 2014 to May 2017, 78 adult patients with femoral shaft fractures were selected and were divided into observation group (40 patients) and control group (38 patients) accorded to the different treatment methods. The observation group was treated with closed reduction intramedullary nail fixation, and the control group was given steel plate internal fixation treatment. The changes of VEGF and HIF-1ɑ expression were recorded. Results: The operation time, the amount of bleeding in the operation, the days of hospitalization after the operation, and the time of fracture healing in the observation group were less than those of the control group (P<0.05). Incidences of complications 1 monthafter operation, such as incision infection, osteomyelitis, venous thrombosis and coxa varus, in the observation group and the control group were 5% and 28.9%, respectively, and the difference were statistically significantly (P<0.05). Excellent and good rates of knee joint 3 months after operation in the observation group and the control group were 95% and 73.7%, respectively, and the difference were statistically significantly (P<0.05). Serum VEGF and HIF-1ɑ levels of the two groups 3 months after operation were higher than those of the preoperative 1d (P<0.05), and that of he observation group were significantly higher than that of the control group (P<0.05).Conclusion: The closed reduction intramedullary nail fixation in the treatment of femoral shaft fracture can promote the expression of VEGF and HIF-1ɑ, reduce the incidence of complications, reduce the trauma to the patients and improve the function of the knee joint.

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