CAJ | 학술논문

目的：探讨肩胛骨外侧缘入路与标准Judet入路方式治疗肩胛骨骨折的效果。方法选取承德医学院附属医院2012年6月~2014年12月收治的肩胛骨骨折患者106例，采用随机数字表法分为观察组和对照组，对应随机数字偶数者为观察组，对应随机数字奇数者为对照组，每组53例。观察组患者采用肩胛骨外侧缘入路手术切口进行内固定治疗，对照组患者采用标准Judet入路手术切开内固定治疗。观察两组患者的手术时间，术中出血量，优良率，患侧肢体疼痛、关节活动、日常活动和肌力评分及不良反应发生率。结果观察组手术时间短于对照组，术中出血量少于对照组，差异有统计学意义(P<0.05)。观察组不良反应发生率为3.77%，对照组不良反应发生率为15.09%，两组比较差异有统计学意义(P<0.05)。观察组优良率明显高于对照组，差异有统计学意义(P<0.05)。治疗后，两组患侧肢体疼痛评分较治疗前降低，患侧关节活动、日常活动及肌力评分较治疗前均增高，差异有统计学意义(P<0.05)；治疗后，观察组患侧关节活动及肌力评分高于对照组，差异有统计学意义(P<0.05)，患侧肢体疼痛及日常活动评分与对照组比较差异无统计学意义(P>0.05)。结论肩胛骨外侧缘入路具有手术时间短、术中出血量少、不良反应发生率低、优良率高等优点，值得临床推广应用。
목적：탐토견갑골외측연입로여표준Judet입로방식치료견갑골골절적효과。방법선취승덕의학원부속의원2012년6월~2014년12월수치적견갑골골절환자106례，채용수궤수자표법분위관찰조화대조조，대응수궤수자우수자위관찰조，대응수궤수자기수자위대조조，매조53례。관찰조환자채용견갑골외측연입로수술절구진행내고정치료，대조조환자채용표준Judet입로수술절개내고정치료。관찰량조환자적수술시간，술중출혈량，우량솔，환측지체동통、관절활동、일상활동화기력평분급불량반응발생솔。결과관찰조수술시간단우대조조，술중출혈량소우대조조，차이유통계학의의(P<0.05)。관찰조불량반응발생솔위3.77%，대조조불량반응발생솔위15.09%，량조비교차이유통계학의의(P<0.05)。관찰조우량솔명현고우대조조，차이유통계학의의(P<0.05)。치료후，량조환측지체동통평분교치료전강저，환측관절활동、일상활동급기력평분교치료전균증고，차이유통계학의의(P<0.05)；치료후，관찰조환측관절활동급기력평분고우대조조，차이유통계학의의(P<0.05)，환측지체동통급일상활동평분여대조조비교차이무통계학의의(P>0.05)。결론견갑골외측연입로구유수술시간단、술중출혈량소、불량반응발생솔저、우량솔고등우점，치득림상추엄응용。
Objective To investigate effect of scapula lateral margin approach and standard Judet approach in the treatment of scapular fracture. Methods 106 patients with scapular fractures from June 2012 to December 2014 in Af-filiated Hospital of Chengde Medical College were selected. They were divided into observation group and control group by using the random number table method. The corresponding random number even as observation group, the corre-sponding digital odd as control group, each group of 53 cases. Observation group was treated with operative treatment through scapula lateral margin approach and control group was treated with surgical treatment through standard Judet approach. Time of operation, intraoperative blood loss, excellent and good rate, pain, joint activity, daily activity and muscle strength score of affected limb, incidence rate of adverse reaction between two groups were compared. Results Time of operation in observation group was shorter than that in control group, and intraoperative blood loss in observa-tion group was less than that in control group, there were statistical differences (P<0.05). Incidence rate of adverse re-action in observation group was 3.77%, incidence rate of adverse reaction in control group was 15.09%, there was sta-tistical difference (P<0.05). Excellent and good rate in observation group was significantly higher than that in control group, with a statistical difference (P<0.05). After treatment, pain score of affected limb in two groups were lower than those before treatment, joint activity, daily activity and muscle strength score of affected limb in two groups were higher than those before treatment, with statistical differences (P< 0.05). After treatment, joint activity and muscle strength score of affected limb in observation group were higher than those in control group, with statistical differences (P <0.05). After treatment, pain and daily activity score of affected limb between two groups had no statistical differences (P> 0.05). Conclusion There are advantages including shorter operation time, less intraoperative blood loss, lower inci-dence rate of adverse reaction, higher excellent and good rate, and it is worthy of clinical promotion and application.