本文關(guān)鍵詞：保守治療與切開復(fù)位內(nèi)固定治療NeerⅢ型肱骨近端骨折的臨床研究　出處：《湖北中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 保守治療 肱骨近端骨折 手術(shù)治療

【摘要】：目的:研究及討論保守治療與切開復(fù)位內(nèi)固定手術(shù)治療NeerⅢ型肱骨近端骨折的臨床治療效果。方法:本研究回顧性分析了2013年10月-2015年10月期間,湖北省中醫(yī)院骨科收入治療的97例臨床診斷為"肱骨近端骨折"且符合錄入研究標(biāo)準(zhǔn)的病例。依據(jù)所給予治療方案的區(qū)別,分為兩組:A組為手術(shù)治療組,使用切開復(fù)位鋼板內(nèi)固定手術(shù)治療;B組為保守治療組,使用中醫(yī)傳統(tǒng)手法整復(fù)、超肩夾板固定以及中藥傷科熏洗湯熏洗治療。通過長海疼痛尺、肢體腫脹分級(jí),比較兩組患者經(jīng)治療后患側(cè)肩部疼痛及腫脹的變化情況。通過Neer評(píng)分系統(tǒng),對(duì)比兩組治療后肩關(guān)節(jié)功能恢復(fù)情況。采用SPSS21版軟件分析。結(jié)果:1.兩組治療前、治療后即刻、治療后第1天、第5天、1周、4周長海疼痛尺評(píng)分情況比較:兩組治療前疼痛情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.9190.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;兩組治療后即刻疼痛情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0000.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后第1天疼痛情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0000.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后第5天疼痛情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0000.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后第4周疼痛情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.8830.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義。2.兩組治療前、治療后即刻、治療后第1天、第5天、1周、4周患肢腫脹分級(jí)情況比較:兩組治療前腫脹程度情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.9540.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;兩組治療后即刻腫脹程度情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.8650.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;兩組治療后第1天腫脹程度情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0000.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后第5天腫脹程度情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0000.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后第4周腫脹程度情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.6780.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義。3.兩組治療后骨折復(fù)位情況比較:兩組治療后復(fù)查X線片,比較骨折復(fù)位情況,經(jīng)過x2檢驗(yàn),P=0.0000.05,故兩組數(shù)據(jù)在統(tǒng)計(jì)學(xué)上有差異。4.兩組治療后3天內(nèi)、第4周、第12周、第24周患側(cè)肩關(guān)節(jié)Neer評(píng)分情況:兩組治療后3天內(nèi)患側(cè)肩關(guān)節(jié)功能情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.2030.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;兩組治療后4周患側(cè)肩關(guān)節(jié)功能情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0000.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后12周患側(cè)肩關(guān)節(jié)功能情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.0010.05,兩組數(shù)據(jù)差異有統(tǒng)計(jì)學(xué)意義;兩組治療后第24周患側(cè)肩關(guān)節(jié)功能情況相比較,經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.6330.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義。5.兩組治療后第24周患側(cè)與健側(cè)肩關(guān)節(jié)Neer評(píng)分情況:A組內(nèi),治療后第24周健側(cè)、患側(cè)肩關(guān)節(jié)功能情況比較,通過配對(duì)t檢驗(yàn),P=0.6790.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;B組內(nèi),治療后第24周健側(cè)、患側(cè)肩關(guān)節(jié)功能情況比較,通過配對(duì)t檢驗(yàn),P=0.4180.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;兩組治療后第24周健側(cè)肩關(guān)節(jié)功能情況比較,通過經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.9860.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義;兩組治療后第24周患側(cè)肩關(guān)節(jié)功能情況比較,通過經(jīng)過兩獨(dú)立樣本t檢驗(yàn),P=0.6330.05,兩組數(shù)據(jù)差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:采用中醫(yī)保守治療NeerⅢ型肱骨近端骨折,患者疼痛、腫脹癥狀緩解快,肩關(guān)節(jié)功能恢復(fù)良好,值得于臨床工作中推廣應(yīng)用。
[Abstract]:Objective: To study and discuss the clinical curative effect of conservative treatment with open reduction and internal fixation for the treatment of Neer type III fractures of the proximal humerus. Methods: This study retrospectively analyzed during October 2013 -2015 October, the clinical diagnosis of 97 cases of the Department of orthopedics of Hubei Provincial Traditional Chinese Medical Hospital for treatment of income "fracture of the proximal humerus and comply with the standards of input cases. On the basis of the difference between treatment plan, divided into two groups: A treatment group for the operation, the use of open reduction and internal fixation surgery; B group for conservative treatment group, using traditional Chinese medicine manipulation, super shoulder splint and traditional Chinese medicine fumigation Decoction fumigation treatment of Department of traumatology. The Changhai pain ruler, limb swelling grade, compared two groups of patients after treatment changes ipsilateral shoulder pain and swelling. The Neer scoring system, the recovery of shoulder joint function were compared between the two groups after treatment. Using SPSS21 software analysis. Results: 1. the two groups before treatment, immediately after treatment, first days, fifth days after treatment, 1 weeks, 4 weeks of Changhai pain ruler score were compared between the two groups: pain before treatment compared by two independent samples t test, P=0.9190.05, no statistically significant differences between the two groups of data; immediate pain after treatment the comparison of the two groups, with two independent samples t test, P=0.0000.05, there were significant differences between the two groups of data; first days of pain were compared after the treatment in the two groups, with two independent samples t test, P=0.0000.05, there were significant differences between the two groups of data; Fifth days of pain were compared in two groups after treatment, after two independent sample t test, P=0.0000.05, there were significant differences between the two groups of data; fourth weeks of pain were compared after the treatment in the two groups, with two independent samples t test, P=0.8830.05, no statistically significant differences between the two groups of data of.2. of two groups before treatment, immediately after treatment, treatment First days after treatment, fifth days, 1 weeks, 4 weeks of limb swelling grade: the swelling degree of the two groups before treatment compared with two independent samples t test, P=0.9540.05, no statistically significant differences between the two groups of data; immediate swelling degree of the two groups after treatment compared with two independent samples t test, P=0.8650.05, no statistically significant differences between the two groups of data; first days of swelling compared the two groups after treatment, after two independent sample t test, P=0.0000.05, there were significant differences between the two groups of data; the two group fifth days after treatment the degree of swelling conditions compared by two independent samples t test, P=0.0000.05, a statistically significant differences between the two groups of data; fourth weeks of swelling after two groups of treatment compared with two independent samples t test, P=0.6780.05, compare the fracture between the two groups was not statistically significant.3. reduction after treatment in two groups: two treatment group After the comparison of X-ray, fracture reduction, through the test of X2, P=0.0000.05, the two sets of data in a statistically significant difference between 3 days and two.4. after treatment, fourth weeks, Twelfth weeks, twenty-fourth weeks of shoulder Neer score: ipsilateral shoulder function condition within 3 days after the treatment in the two groups after comparison, two independent samples t test, P=0.2030.05, no statistically significant differences between the two groups of data; 4 weeks of shoulder joint function after the treatment in the two groups compared by two independent samples t test, P=0.0000.05, there were significant differences between the two groups of data; 12 weeks of shoulder joint function after the treatment in the two groups after comparison, two independent samples t test, P=0.0010.05, there were significant differences between the two groups of data; twenty-fourth weeks of ipsilateral shoulder joint function were compared after the treatment in the two groups, with two independent samples t test, P=0.6330.05, data of the two groups the difference was statistically significant in two groups.5. Score after twenty-fourth weeks and the contralateral side of shoulder joint Neer: A group within twenty-fourth weeks after treatment compared with the contralateral, ipsilateral shoulder function, by the paired t test, P=0.6790.05, no statistically significant differences between the two groups of data; in the B group, twenty-fourth weeks after treatment of contralateral, ipsilateral shoulder joint function to compare, by paired t test, P=0.4180.05, no statistically significant differences between the two groups of data; two groups twenty-fourth weeks after treatment of contralateral shoulder function compared to the situation, through the two independent samples t test, P=0.9860.05, no statistically significant differences between the two groups of data comparison; twenty-fourth weeks of shoulder joint function after the treatment in the two groups after two, through independent sample t test, P=0.6330.05, no statistically significant differences between the two groups of data. Conclusion: the traditional Chinese medicine conservative treatment of Neer type III fractures of the proximal humerus, pain, swelling and relieve symptoms quickly, good recovery of shoulder joint function, worth in clinical work In the application.

【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R274.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張登峰;;肱骨近端骨折術(shù)后肩功能康復(fù)中應(yīng)用運(yùn)動(dòng)療法的臨床價(jià)值分析[J];中國實(shí)用醫(yī)藥;2015年22期

2 許京芝;;康復(fù)治療訓(xùn)練在肱骨骨折術(shù)后的應(yīng)用效果[J];中國當(dāng)代醫(yī)藥;2014年31期

3 曾浪清;唐三元;;肱骨近端骨折的流行病解剖分型及影像學(xué)研究進(jìn)展[J];中國矯形外科雜志;2014年18期

4 李玲;;骨折康復(fù)的治療與減少關(guān)節(jié)并發(fā)癥作用分析[J];中國醫(yī)藥指南;2013年04期

5 陸根華;謝國華;牟曉峰;薛峰;楊建平;;解剖型鎖定鋼板治療肱骨外科頸骨折的初步分析[J];現(xiàn)代醫(yī)藥衛(wèi)生;2012年20期

6 王積明;;肱骨骨折不愈合的原因及治療[J];基層醫(yī)學(xué)論壇;2012年19期

7 金崢;;淺談骨折康復(fù)[J];基層醫(yī)學(xué)論壇;2009年28期

8 顏曉峰;曾參軍;劉宇林;;肱骨近端復(fù)雜骨折的手術(shù)治療探討[J];實(shí)用預(yù)防醫(yī)學(xué);2007年02期

9 王燁;馮德宏;王凌;;粉碎性肱骨近端骨折的手術(shù)治療體會(huì)[J];中國矯形外科雜志;2006年22期

10 孫月華,龔偉華,朱振安,史定偉,唐堅(jiān),戴克戎;肱骨近端骨折的手術(shù)治療[J];中華手外科雜志;2005年05期

，

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