Lu Yi, Wang Xue-song, Sun Lin, Wang Man-yi
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Wai Ke Za Zhi. 2006 Feb 15;44(4):264-7.
To investigate the rate of systemic inflammatory response syndrome (SIRS) among patients treated by intramedullary nail (IMN) for femoral shaft fracture right after the operation, the effect of femoral nailing on SIRS and sought to differentiate any differences between reamed and unreamed IMN.
Three hundred and twenty-four patients presenting with acute femoral fractured from April 1997 to April 2005, divided into 2 group depending on ISS. Group 1 had 179 patients (ISS < 16, AIS < 2) including 64 reamed cases and 115 unreamed cases; group 2 had 145 patients (ISS >or= 16, AIS >or= 2) including 51 reamed patients and 94 unreamed. All patients were treated by close reduction and intramedullary nail for fixation. The heart rate, breath rate, temperatures were recorded every 6 h before and after operation. If any of the life sign was above normal, then venous blood samples were taken at once to make sure whether SIRS occurred or not. All data were crosstabs analysis by SPSS 10.0.
One hundred and twenty-four patients suffered from SIRS postoperation. In group 1, 24 reamed and 37 unreamed, in group 2, 27 reamed and 36 unreamed. Among those SIRS, 119 cases healed evenly and 5 patients developed further complication. Between reamed and unreamed patients both in group 1 and group 2, there was no significant difference found. The Chi-Square value were 0.159 and 2.885 respectively, total value was 3.467, which P was 0.325, 0.089 and 0.471, all greater than 0.05.
Although SIRS will result from IMN, there is no significant different effect on the rate of SIRS found between reamed and unreamed nail in both group.
探讨股骨干骨折患者术后采用髓内钉（IMN）治疗后全身炎症反应综合征（SIRS）的发生率、股骨钉固定对SIRS的影响，并试图区分扩髓与非扩髓IMN之间的差异。
选取1997年4月至2005年4月间324例急性股骨干骨折患者，根据损伤严重度评分（ISS）分为2组。第1组179例（ISS<16，简明损伤定级标准（AIS）<2），包括64例扩髓病例和115例非扩髓病例；第2组145例（ISS≥16，AIS≥2），包括51例扩髓患者和94例非扩髓患者。所有患者均采用闭合复位髓内钉固定。分别于手术前后每6小时记录心率、呼吸频率及体温。若任何一项生命体征高于正常，则立即采集静脉血样本以确定是否发生SIRS。所有数据采用SPSS 10.0进行交叉表分析。
124例患者术后发生SIRS。第1组中，扩髓组24例，非扩髓组37例；第2组中，扩髓组27例，非扩髓组36例。在这些发生SIRS的患者中，119例愈合良好，5例出现进一步并发症。第1组和第2组的扩髓与非扩髓患者之间均未发现显著差异。卡方值分别为0.159和2.885，总值为3.467，P值分别为0.325、0.089和0.471，均大于0.05。
尽管IMN会引发SIRS，但两组中扩髓钉与非扩髓钉对SIRS发生率的影响无显著差异。
