[1]马兵兵,王鹏国.不同手术时机肋骨环抱器手术对肋骨骨折大鼠预后影响的实验研究[J].陕西医学杂志,2021,50(7):780-783,788.[doi:DOI:10.3969/j.issn.1000-7377.2021.07.003]
　MA Bingbing,WANG Pengguo.Effect of rib embracing device surgery at different operation timing on the prognosis of rib fracture rats[J].,2021,50(7):780-783,788.[doi:DOI:10.3969/j.issn.1000-7377.2021.07.003]
点击复制

不同手术时机肋骨环抱器手术对肋骨骨折大鼠预后影响的实验研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年7期
页码:
780-783,788
栏目:
基础研究
出版日期:
2021-07-05

文章信息/Info

Title:
Effect of rib embracing device surgery at different operation timing on the prognosis of rib fracture rats
作者:
马兵兵1; 王鹏国2
(1.兵器工业五二一医院心胸外科,陕西 西安 710065; 2.陕西省核工业二一五医院,陕西 咸阳 712000)
Author(s):
MA Bingbing; WANG Pengguo
(Department of Cardiothoracic Surgery,521 Hospital of Norinco Group,Xi'an 710065,China)
关键词:
肋骨骨折;  手术时机;  环抱器;  骨折愈合;  免疫反应;  血管内皮生长因子;  骨形态发生蛋白-2
Keywords:
Rib fracture;  Operation timing;  Embracing device;  Fracture healing;  Immune response;  Vascular endothelial growth factor;  Bone morphogenetic protein-2
分类号:
R 683.1
DOI:
DOI:10.3969/j.issn.1000-7377.2021.07.003
文献标志码:
A
摘要:
目的:探讨不同手术时机肋骨环抱器手术对肋骨骨折大鼠预后的影响。方法:将建模成功的肋骨骨折大鼠(n=48)随机平分为模型组、早期组与晚期组,早期组与晚期组分别在建模后1 d与3 d后进行环抱器手术治疗,模型组不进行环抱器手术。结果:早期组与晚期组的术后第1周、第2周骨小梁宽度、骨小梁成骨指数都高于模型组(均P<0.05),早期组高于晚期组(P<0.05)。早期组与晚期组的术后第1周、第2周的血清核因子kappaB受体活化因子配体(RANKL)含量低于模型组(均P<0.05),血清骨保护素(OPG)含量高于模型组(均P<0.05),早期组与晚期组对比差异有统计学意义(P<0.05)。早期组与晚期组的术后第1周、第2周的血浆血管内皮生长因子(VEGF)与骨形态发生蛋白-2(BMP-2)含量高于模型组(均P<0.05),早期组高于晚期组(均P<0.05)。早期组与晚期组的术后第1周、第2周的CD4+T淋巴细胞比例高于模型组(P<0.05),早期组高于对照组(P<0.05),三组不同时间点的CD8+T淋巴细胞比例对比差异无统计学意义(均P>0.05)。结论:早期环抱器手术在肋骨骨折大鼠的应用能改善机体免疫反应,促进VEGF、BMP-2、OPG的释放,抑制RANKL的表达,从而促进骨折愈合。
Abstract:
Objective:To compare the effect of rib embracing device surgery at different surgical timing on the prognosis of rib fracture rats.Methods:The successfully modeled rib fracture rats(n=48)were equally randomly divided into model group,early group and late group.The early group and the late group were treated with embracing device surgery 1 and 3 days after modeling,and the model group was not treated embracing device surgery.Results:The trabecular bone width and trabecular osteogenesis index of the early group and the late group in the first and second week after surgery were higher than those of the model group,and the early group were higher than the late group(all P<0.05).The serum RANKL levels of the early group and the late group in the first and second week after surgery were lower than that of the model group,and the serum OPG content was higher than that of the model group,and there was statistically significant difference between the early group and the late group(all P<0.05).The plasma VEGF and BMP-2 levels of the early group and the late group in the first and second week after surgery were higher than those of the model group,and the early group were higher than the late group(all P<0.05).The ratio of CD4+T lymphocytes of the early group and the late group in the first and second week after surgery was higher than that of the model group,and the early group was higher than the late group(all P<0.05).There was no statistically significant difference in the ratio of CD8+T lymphocytes between the three groups at different time points(all P>0.05).Conclusion:The application of early embracing device surgery for rib fracture rats can improve the body's immune response,promote the release of VEGF,BMP-2,OPG and inhibit the expression of RANKL,thereby promote fracture healing.

参考文献/References:

[1] 刘聚良,苗 琳,王海军,等.红花注射液与接骨板结合术治疗多发肋骨骨折疗效观察[J].陕西中医,2014,35(4):450-451.
[2] 罗振国,邵冠一,易双强,等.罗哌卡因局部浸润联合地佐辛肌肉注射对多发肋骨骨折患者术后镇痛的影响[J].陕西医学杂志,2017,46(10):1463-1464,1476.
[3] 李智勇,齐东海.多小切口肋骨手术31例临床分析[J].陕西医学杂志,2015,44(10):1328-1330.
[4] Kim M,Moore JE.Chest trauma:Current recommendations for rib fractures,pneumothorax,and other injuries[J].Curr Anesthesiol Rep,2020,10(1):61-68.
[5] Long R,Tian J,Wu S,et al.Clinical efficacy of surgical versus conservative treatment for multiple rib fractures:A meta-analysis of randomized controlled trials[J].Int J Surg,2020,83(14):79-88.
[6] Marcussen B,Negaard M,Hosey RG,et al.A case series and literature review:Isolated traumatic first rib fracture in athletes[J].Clin J Sport Med,2020,30(3):257-266.
[7] 刘东喆.胸腔镜辅助下记忆合金环抱器治疗多根多发肋骨骨折的可行性研究[J].中国伤残医学,2020,28(2):21-22.
[8] 李天向.胸腔镜辅助点式小切口肋骨环抱器内固定治疗多根多处肋骨骨折连枷胸的效果[J].实用临床医学,2020,21(7):33-35.
[9] 高泽文.连枷胸使用镍钛记忆合金环抱器内固定手术的疗效分析[J].山西医药杂志,2020,49(4):422-423.
[10] Choi J,Gomez GI,Kaghazchi A,et al.Surgical stabilization of rib fracture to mitigate pulmonary complication and mortality:A systematic review and bayesian meta-analysis[J].J Am Coll Surg,2021,232(2):211-219.
[11] Coary R,Skerritt C,Carey A,et al.New horizons in rib fracture management in the older adult[J].Age Ageing,2020,49(2):161-167.
[12] 王忠义,范清娥.肋骨环抱器手术治疗多发性肋骨骨折并呼吸衰竭效果观察[J].中国药物与临床,2020,20(13):2235-2236.
[13] 李 陶,鲁圣山,刁俊生,等.环抱式接骨器内固定对多发肋骨骨折患者术后疼痛、呼吸功能及骨折愈合的影响[J].中国临床医生杂志,2020,48(7):851-853.
[14] 陈 松,丁世陆.环抱式接骨器内固定术治疗多发性肋骨骨折的临床效果[J].安徽医学,2020,41(3):320-322.
[15] Dogrul BN,Kiliccalan I,Asci ES,et al.Blunt trauma related chest wall and pulmonary injuries:An overview[J].Chin J Traumatol,2020,23(3):125-138.
[16] Ho AM,Ho AK,Mizubuti GB,et al.Regional analgesia for patients with traumatic rib fractures:A narrative review[J].J Trauma Acute Care Surg,2020,88(1):22-30.
[17] Salles JP.Hypophosphatasia:Biological and clinical aspects,avenues for therapy[J].Clin Biochem Rev,2020,41(1):13-27.
[18] 张保友,孔劲松,卢海彬,等.环抱器联合肋间神经阻滞在多发性肋骨骨折中的应用[J].中华全科医学,2020,18(9):1496-1499.
[19] 张 帆,张 潍,孙党泽,等.镍钛记忆合金治疗创伤性连枷胸的临床效果及对骨形态发生蛋白和炎性因子水平的影响[J].中国医药,2020,15(9):1428-1431.
[20] Wardhan R,Kantamneni S.The challenges of ultrasound-guided thoracic paravertebral blocks in rib fracture patients[J].Cureus,2020,12(4):7626-7632.
[21] Williams A,Bigham C,Marchbank A.Anaesthetic and surgical management of rib fractures[J].BJA Educ,2020,20(10):332-340.
[22] Xia H,Zhu D,Li J,et al.Current status and research progress of minimally invasive surgery for flail chest[J].Chiropr Man Therap,2020,19(1):421-427.
[23] 钟源波,王 进,许士海,等.胸腔镜辅助肋骨固定与传统手术病例对照研究[J].中华急诊医学杂志,2020,29(9):1214-1218.

相似文献/References:

[1]夏航校,郑建勇,陈巧玲,等.产伤性直肠阴道瘘手术治愈率影响因素分析[J].陕西医学杂志,2021,50(6):705.[doi:DOI:10.3969/j.issn.1000-7377.2021.06.016]

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2019SF-043)
更新日期/Last Update: 2021-07-05