中国康复医学杂志，2009年，第24卷，第10期
921
.临床研究·
液电式及电磁式体外冲击波治疗骨不连及
骨折延迟愈合效果比较杨杰华：
彭小文1梁秋雁1
张盘德！
目的：比较国产液电式及电磁式体外冲击波(ESW)治疗骨不连及骨折延退合的效果及安全性。方法：随机
摘要
抽取液电式及电磁式ESW治疗骨不连及骨折延迟愈合患者112例，每月进行X线片复查，了解骨折愈合情况。ESW 治疗3个月后如骨折处无明显骨痴生长,则再行1疗程ESW治疗。结果：电磁式ESW组治疗56例，3例无效,53例有较明显骨痴生长，骨痴出现时间为4--12周；其中48例最终骨折完全愈合骨折愈合时闻为8一25周；治疗总有效率为94.64%，治愈率为85.71%。电磁式ESW治疗后观察到肢体神经血管损伤等并发症少。电磁式组与液电式组比较疗效及安全性差异有显著性意义(P<0.01)。结论：电磁式ESW治疗骨不连及骨折延愈合的疗效优于液电式ESW
机;ESW治疗骨不连及骨折延迟愈合疗效可靠、创伤小、方法简单安全。关键调体外冲击波；骨折；不愈合；骨不连
中图分类号：R683，R493
文献标识码：A
文章编号：10011242(2009)10092103
Comparison of effect of electrohydraulic and electromagnetic extracorporeal shock waves on bone nonunions and fractare disunite/YANG Jiehua,ZHANG Pande,PEN Xiaowen,et al//Chinese Journal of Rehabilitation Medicine, 2009,24(10): 921—923
Objective:To compare the effectiveness and safety of electrohydraulic and electromagnetic extracorporeal
Abstract
shock waves (ESW) on
bone nonunions and fracture disunite. Method:A total of 112 cases suffered from bone
were randomly chosen. To observe the state of healing, the parts
nonunions and fracture disunite treated with ESW of fractures were examined
with Xray
monthly.
If no conspicuous
osteotylus appeared after the first 3 months
s would take another counse of ESW treatment. Result: Electromagnetic ESW treatments
course of ESW the patients
were performed in 56 cases, in which 3 cases
didn's get effect, 53 cases had conspicuous osteotylus within 4
12weeks and 48 cases of them achieved complete healing with in 8—25 weeks. Healing rate was 85.71%, total
serious complications.
effectiveratewas94.64%with few
Compared with electrohydraulic ESW
ytreatment，
electromagnetic ESW treatment possessed obvious advantages in effectiveness and safety (P<0.01). Conclusion:The overall effects of electromagnetic ESW trealment on bone nonunions and fracture disunite are better than those of clectrohydraulie ESW treatment. ESW treatment is a safe, simple and effective method for bone nonunion and fracture disunite.
Author's addressDept. of Rehabilitation Medicine,The First Foshan Hospital,Foshan,528000 Key wordsextracorporeal shock waves;fracture;disunite;bone nonunions
骨不连是骨科领域常见的难治性疾病之一,骨
折后约有5%10%的患者会发生骨不连.植骨及局部内固定为最常用的传统治疗方法，但仍有一部分患者术后不能及时愈合。自20世纪80年代起国外学者开始研究冲击波对骨组织的影响，发现体外冲击波具有促进骨折愈合的作用，大量临床研究结果是令人满意的。我院2004年开展体外冲击波(extracorporealshockwaves，ESW）治疗骨不连及骨折延迟愈合，取得了满意的疗效
1资料与方法 1般资料 1.1
选取我院骨科和复科2006年6月一2009年
6月骨不连及骨折延迟愈合患者112例，随机分为液电式ESW治疗组与电磁式ESW治疗组，各56 例；男78例,女34例；平均年龄(45±5.7)岁；其中骨不连38例,病程6个月2年；骨折延退愈合74例，病程3一6月；骨不连病例中,股骨19例,胫骨9例，肱骨5例,桡骨5例；骨折延迟愈合中,股骨29例,胫骨20例脑骨17例,桡骨8例；其中51例有内固定。
病例选择标准；骨折延迟愈合为骨折后治疗超
*基金项目：广东佛山市卫生局科研立项(2007) 佛山市第一人民医院康复医学科，528000
作者篇介：杨杰华，男，主治医师收稿日期：2009-06-21