关节镜下胫骨平台骨折手术治疗中临床路径的实施及效果评价

吴龙昌，温玲珠*

（西安市未央区中医医院骨伤科，陕西 西安，710016）

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摘要：

目的 探讨关节镜下胫骨平台骨折手术治疗中临床路径的实施方法及效果。方法 选择2012年1月至2015年6月本院收治的胫骨平台骨折患者80 例，按照随机数字法分为两组，各40例。观察组实施临床路径，对照组实施常规救治。比较两组 获得手术治疗时间、总住院时间，治疗前、后ROM角度及Lysholm 关节功能评分，相关并发症发生情况及临床效果。结果 观察组的手术治疗时间及总住院时间均显著短于对照组，差异具有统计学意义（P<0.05）；治疗后，观察组ROM 角度大于治疗 前及对照组治疗后（P<0.05），Lysholm 关节功能评分高于治疗前及对照组治疗后（P<0.05）；观察组发生关节内感染、伤口延迟 愈合、内固定物断裂或松动及膝关节畸形的总发生率显著低于对照组（P<0.05）；观察组优良率高于对照组，差异具有统计学 意义（P<0.05）。结论 针对关节镜辅助治疗胫骨平台骨折患者实施临床路径指导医疗过程，可显著缩短患者获得救治时间，减少住院时间，提高手术治疗效果，减少相关并发症。

关键词：关节镜；胫骨平台骨折；临床路径

中图分类号：R473.6文献标志码：A文章编号：2096-1413(2018)01-0046-03

Implementation and evaluation of clinical pathways in surgical treatment of tibial plateau fractures under arthroscopy
WU Long-chang, WEN Ling-zhu
(Orthopedics Department, Traditional Chinese Medicine Hospital of Weiyang District, Xi``an 710016, China)

ABSTRACT: Objective To explore the application methods and effect of clinical pathways in surgical treatment of tibial plateau fractures under arthroscopy. Methods Eighty cases of patients with tibial plateau fracture admitted in our hospital from January 2012 to June 2015 were divided into two groups according to the random number method, with 40 cases in each group. The observation group was treated with the clinical path of this study. The control group was treated with routine treatment. The operation time, total length of hospital stay, ROM angle and Lysholm joint function score before and after treatment, related complications and clinical effects were compared in the two groups. Results The operative time and total hospital stay in the observation group were significantly shorter than those in the control group, the differences were statistically significant (P<0.05). After treatment, the ROM angle of the observation group was bigger than that before treatment and that of the control group after treatment (P<0.05), and the Lysholm joint function score was higher than that before treatment and that of the control group after treatment (P<0.05). The total rate of intra-articular infection, delayed
wound healing, internal fixation rupture or loosening and knee deformity in the observation group was significantly lower than that in the control group (P<0.05). And the excellent rate of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion The clinical pathways of patients with tibial plateau fractures treated by arthroscopy can significantly reduce the time of treatment, shorten the length of hospital stay, improve the effect of surgical treatment and reduce the related complications.
KEYWORDS: arthroscopy; tibial plateau fracture; critical pathways

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