鼠神经生长因子治疗创伤性骨不连临床研究
Clinical study of rat nerve growth factor on treating traumatic nonunion
目的 探讨局部注射神经生长因子在治疗骨折不愈合与延迟愈合中的作用。 方法 研究对象选取我院2014年1月到2016年1月间收治的四肢骨折不愈合患者86例，按照随机数字法分为对照组(43例)和观察组(43例)，对照组患者采用组合式外固定支架结合常规康复训练治疗，观察组患者联合局部神经生长因子注射治疗，比较两组患者的治疗有效率，同时比较两组患者的4周内和4周后的骨痂最大直径、骨痂出现时间、骨痂体积、骨折愈合时间和不良反应发生率。 结果 观察组的总有效率为97.67%明显高于对照组(81.4%)(χ2=6.08，P<0.01)；观察组的胫骨、股骨、肱骨、尺骨、锁骨、腓骨及桡骨等愈合时间均明显低于对照组(P<0.01)；治疗4周内骨痂的最大直径比较中两组无统计学差异(P>0.05)；治疗4周后观察组的骨痂最大直径明显高于对照组(t=2.659, P<0.01)；观察组骨痂出现时间、骨折愈合时间均明显早于对照组(P<0.01)；两组患者在8周内均无严重不良反应发生，组间比较无统计学差异(P>0.05)。 结论 局部注射神经生长因子治疗骨折不愈合与延迟愈合患者的临床疗效显著，能明显提高骨折的治疗有效率，促进骨痂生成和骨折愈合速度，同时患者的不良反应发生率较少，治疗安全性高，值得在临床中推广。
Objective To investigate the efficacy of treatment of nonunion and delayed union with local injection of nerve growth factor. Methods 86 patients with limb fracture nonunion treated in our hospital between January 2014 to January 2016 were in enrolled in this study which was randomized into the control group (43 cases) and observation group (43 cases). Patients in the control group underwent a modular external fixation combined with conventional rehabilitation therapy; patients in the observation group received additional local injection of nerve growth factor treatment. The therapeutic efficiency was compared in the two groups. The maximum diameter of callus within and over 4 weeks, the volume of callus, fracture healing time, quality of life and incidence of adverse reactions were also compared. Results Total effective rate was 76.7% and 95.3% in the observation group and the treatment group, respectively, with significant difference detected(χ2 = 8.39, P <0.01); the healing time of tibia, femur, humerus, ulna, clavicle, fibula and radius was significantly shorter in observation group than the control group (P<0.01); no significant difference in the maximum diameter of callus was found between the two groups (P>0.05); 4 weeks after treatment, the maximum diameter of callus in observation group was significantly higher (t=2.576, P<0.01); callus occurrence time, and fracture healing time was significantly earlier in the observation group than in the control group (P<0.01); no significant difference in the incidence of serious adverse events within 8 weeks were found in the two groups of patients (P>0.05). Conclusion Clinical efficacy of local injection of nerve growth factor in the treatment of nonunion and delayed union in patients with significant, which can significantly improve the treatment of fractures of efficiency, promoting callus formation and fracture healing, and lowering incidence of adverse reactions in patients, improving treatment safety, making this method worth popularizing in clinic.
Nerve growth factor / Injection / Nonunion / Clinical research
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