中华临床医师杂志(电子版) 2017年2月,11卷3期

临床论著

外固定支架联合负压封闭引流术治疗严重软组织损伤胫腓骨骨折的临床研究

马文书

054000 河北省,邢台矿业集团总医院急诊科
马文书,Email: 365704801@qq.com

摘要:  目的 探究与分析外固定支架联合负压封闭引流术治疗严重软组织损伤胫腓骨骨折的临床效果。方法 回顾分析2012年9月至2015年9月在本院住院的52例严重软组织损伤胫腓骨骨折患者,按照时间就诊顺序分为对照组与观察组,每组各26例,对照组仅给予外固定支架,观察组在其基础上加用负压封闭引流术,对比两组患者Mazur踝关节功能、手术处理时间、住院天数、换药次数、抗生素费用、治疗后创面面积、医疗费用、更换引流管次数、植皮全部成活率、植皮部分坏死率、感染复发率。计数资料采用χ2检验,计量资料采取t检验,以均数±标准差()的形式对数据进行表示,以P<0.05代表差异有统计学意义。结果 观察组与对照组Mazur踝关节功能评分优良率为69.23%、88.46%,观察组与对照组相比Mazur踝关节功能评分优良率所占比例较高,差异具有统计学意义(P<0.05)。观察组与对照组相比手术处理时间为(13.23±2.56)d、(8.69±2.61)d;住院天数为(30.23±6.90)d、(20.56±7.23)d;抗生素费用(289.23±41.22)元、(200.56±38.90)元;医疗费用(7 255.34±410.25)元、(5 450.90±334.56)元;换药次数(7.21±2.89)次、(1.90±0.34)次;治疗后创面面积(13.22±1.45)cm2、(9.09±1.46)cm2;更换引流管次数(3.67±0.30)次、(1.98±0.56)次。观察组与对照组相比手术处理时间、住院天数缩短,抗生素费用、医疗费用降低,换药次数、更换引流管次数减少,治疗后创面面积缩小,差异具有统计学意义(P<0.05)。结论 采用外固定支架联合负压封闭引流术治疗严重软组织损伤胫腓骨骨折的临床效果显著。

关键词:外固定支架; 负压封闭引流术; 严重软组织损伤; 胫腓骨骨折

Clinical research of external fixation combined with vacuum sealing drainage in the treatment of tibiofibular fracture associated with severe soft tissue injury

Ma Wenshu.

Department of Emergency, The General Hospital of Xingtai Mining Industry Bloc, Xingtai 054000, China
Ma Wenshu, Email: 365704801@qq.com

Abstract:  Objective To explore and analysis of the clinical effects of external fixation combined with vacuum sealing drainage (VSD) in the treatment of tibiofibular fracture associated with severe soft tissue injury. Methods Fifty two cases of patients with severe soft tissue injuries with tibiofibular fracture in our hospital from September 2012 to September 2015, according to the order of treatment time, were divided into control group and observation group, with 26 patients in each group. Control group were only given the external fixation. Besides the external fixation, observation group were treated with vacuum sealing drainage. Comparing two groups of patients with Mazur ankle function, operation time, hospitalization days, dressing frequency, antibiotics cost, wound area after treatment, medical expenses, the number of changing drainage tube, all the skin graft survival rate, necrosis rate of the partial skin, and recurrence rate of infection. Results The proportion of excellent and good rate of Mazur ankle function in observation group was higher than control group (88.46% vs. 69.23%), the differences were statistically significant (P<0.05). Comparing with control group, operation processing time, hospitalization days, (8.69±2.61) days and (20.56±7.23) days, shorter than the observation group, (13.23±2.56) days and (30.23±6.90) days. And the cost of antibiotics, (289.23±41.22) yuan vs. (200.56±38.9) yuan, medical costs, (7 255.34±410.25) yuan vs. (5 450.9±334.56) yuan, the dressing frequency, (7.21±2.89) times vs. (1.90±0.34) times, the wound area after treatment (13.22±1.45) cm2 vs. (9.09±1.46) cm2, the number of changing drainage tube, (3.67±0.30) times vs. (1.98±0.56) times. Comparing with control group, the observation group shortened the operation time and hospitalization days, reduced the cost of antibiotics and medical expenses, decreased the frequency of dressing and changing drainage tube, lessened the wound area after treatment, and the differences were statistically significant (P<0.05). Conclusion The effect of external fixation combined with vacuum sealing drainage (VSD) in the treatment of severe soft tissue injuries tibiofibular fracture is remarkable.

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(编辑:马超 收稿日期:2016-10-18)