摘要目的:探讨高压氧促进骨质疏松性骨折术后患者愈合的效果及其作用机制。方法:选取2019年9月至2021年4月长治医学院附属和济医院骨科收治的骨质疏松性骨折术后患者98例作为研究对象，按照随机数字表法分为对照组和研究组，每组49例。对照组予以手术复位、固定、功能锻炼及神经生长因子治疗，研究组在对照组治疗的基础上联合高压氧治疗。评估2组患者治疗后的临床疗效。采用骨密度仪测量并计算患者治疗前后骨密度参数（BMDP），采用酶联免疫吸附法测定患者血清中成骨生长因子、炎性因子、氧化应激因子及骨代谢指标。采用苦味酸法测定血肌酐（Cr）水平。结果:研究组临床治疗有效率（95.92%）显著高于对照组（83.67%），差异有统计学意义（ χ2=4.009， P<0.05）。与治疗前比较，2组患者治疗后骨钙素N端中分子片段（N-MID）、胰岛素样生长因子-1（IGF-1）和可溶性细胞间黏附分子（sICAM-1）水平增高（ P<0.05）；与对照组治疗后比较，研究组治疗后N-MID、sICAM-1和IGF 1水明显增高（ P<0.05）。与对照组治疗后比较，研究组治疗后血清超氧化物歧化酶（SOD）、总抗氧化能力（T-AOC）、骨碱性磷酸酶（BAP）、骨钙素（OC）水平明显提高，晚期氧化蛋白产物（AOPP）、代谢酶单胺氧化酶A（MAOA）、白细胞介素-1（IL-1）、IL-6、肿瘤坏死因子-α（TNF-α）、Ⅰ型胶原交联C端肽（CTx）及尿Ⅰ型胶原交联N端肽（uNTx）/Cr、BMDP水平明显降低，差异均有统计学意义（ P<0.05）。 结论:高压氧综合治疗可以促进骨质疏松性骨折患者术后愈合，其作用机制主要是通过减轻机体炎症、氧化应激反应，刺激成骨细胞生长因子，改善骨代谢，促进骨形成，进而增加骨密度而实现的。

abstractsObjective:To investigate the effects and possible action mechanism of hyperbaric oxygen on postoperative healing of osteoporotic fractures.Methods:A total of 98 patients with osteoporotic fractures treated by Department of Orthopedics of Heji Hospital Affiliated to Shanxi Changzhi Medical College between September 2019 and April 2021 were randomly assigned to either the control group or the research group，with 49 patients in each group. In addition to the routine treatments for all patients，e.g.，operative reduction，fixation，functional exercise，and nerve growth factor therapy，the research group was additionally treated with hyperbaric oxygen. The clinical efficacies of the treatments for the two groups were evaluated as follows：The bone mineral density parameters（BMDP）before and after the treatments were measured. The levels of insulin like growth factor-1（IGF-1），soluble intercellular adhesion molecule-1（sICAM-1），inflammatory factors［interleukin-1（IL-1），interleukin-6（IL-6），and tumor necrosis factor-α（TNF-α）］，oxidative stress factors，and serum bone metabolism parameters were determined by enzyme-linked immunosorbent assay（ELISA）. The urine creatinine level was measured by picric acid method，and the cross linked N-terminal peptide of urinary type I collagen / creatinine（uNTx/Cr）value was calculated.Results:The clinical effective rate of the research group（95.92%）was significantly higher than that of the control group（83.67%），with statistically significant difference（ χ2=4.009， P<0.05）. After the treatment，the levels of N-terminal middle molecular fragment of osteocalcin（N-MID），IGF-1，and sICAM-1 were increased（ P<0.05）in both groups；and the increases in the research group were significantly higher than those in the control group（ P<0.05）. Compared with the control group after the treatment，the levels of SOD，total antioxidant capacity（T-AOC），bone alkaline phosphatase（BAP），and osteocalcin（OC）in the research group were more significantly raised；and the levels of advanced oxidation protein products（AOPP），metabolic enzyme monoamine oxidase A（MAOA），IL-1，IL-6，TNF-α，crosslinked C-terminal peptide of type I collagen（CTx），uNTx/Cr，and BMDP in the research group were more significantly reduced，all the differences were statistically significant（ P<0.05）. Conclusion:Hyperbaric oxygen can promote the postoperative healing of osteoporotic fractures，which may be related to its role in reducing inflammation and oxidative stress and improving bone metabolism，hence increased bone density and enhanced healing.