中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
8期
16-18
,共3页
胫骨%腓骨%骨折%外固定器
脛骨%腓骨%骨摺%外固定器
경골%비골%골절%외고정기
Tibia%Fibula%Fractures,bone%External fixators
目的 探讨早期外固定架固定的损伤控制性手术治疗严重多发伤伴开放性胫腓骨骨折患者的疗效.方法 回顾性分析2006年6月至2011年2月收治的58例严重多发伤[损伤严重度评分(ISS)＞ 16分]伴开放性胫腓骨骨折患者的临床资料,根据应用损伤控制策略不同分为两组,观察组32例应用外固定架固定治疗；对照组26例应用跟骨牵引或石膏外固定治疗,对比分析两组患者创面愈合时间、骨折愈合时间、1个月内多器官功能障碍综合征(MODS)、急性呼吸窘迫综合征(ARDS)发生率及病死率、创面感染率.结果 观察组1个月内ARDS发生率、创面感染率和创面愈合时间分别为6.25％(2/32)、31.25％(10/32)和(21.47±6.84)d,对照组分别为24.00％(6/25)、64.00％(16/25)和(30.26±2.18)d,两组比较差异有统计学意义(P＜0.05)；观察组1个月内MODS发生率、病死率、骨折愈合时间与对照组比较差异无统计学意义(P＞0.05).结论 早期外固定架固定的损伤控制性手术治疗严重多发伤并开放性胫腓骨骨折,有利于减少并发症发生,提高救治成功率.
目的 探討早期外固定架固定的損傷控製性手術治療嚴重多髮傷伴開放性脛腓骨骨摺患者的療效.方法 迴顧性分析2006年6月至2011年2月收治的58例嚴重多髮傷[損傷嚴重度評分(ISS)＞ 16分]伴開放性脛腓骨骨摺患者的臨床資料,根據應用損傷控製策略不同分為兩組,觀察組32例應用外固定架固定治療；對照組26例應用跟骨牽引或石膏外固定治療,對比分析兩組患者創麵愈閤時間、骨摺愈閤時間、1箇月內多器官功能障礙綜閤徵(MODS)、急性呼吸窘迫綜閤徵(ARDS)髮生率及病死率、創麵感染率.結果 觀察組1箇月內ARDS髮生率、創麵感染率和創麵愈閤時間分彆為6.25％(2/32)、31.25％(10/32)和(21.47±6.84)d,對照組分彆為24.00％(6/25)、64.00％(16/25)和(30.26±2.18)d,兩組比較差異有統計學意義(P＜0.05)；觀察組1箇月內MODS髮生率、病死率、骨摺愈閤時間與對照組比較差異無統計學意義(P＞0.05).結論 早期外固定架固定的損傷控製性手術治療嚴重多髮傷併開放性脛腓骨骨摺,有利于減少併髮癥髮生,提高救治成功率.
목적 탐토조기외고정가고정적손상공제성수술치료엄중다발상반개방성경비골골절환자적료효.방법 회고성분석2006년6월지2011년2월수치적58례엄중다발상[손상엄중도평분(ISS)＞ 16분]반개방성경비골골절환자적림상자료,근거응용손상공제책략불동분위량조,관찰조32례응용외고정가고정치료；대조조26례응용근골견인혹석고외고정치료,대비분석량조환자창면유합시간、골절유합시간、1개월내다기관공능장애종합정(MODS)、급성호흡군박종합정(ARDS)발생솔급병사솔、창면감염솔.결과 관찰조1개월내ARDS발생솔、창면감염솔화창면유합시간분별위6.25％(2/32)、31.25％(10/32)화(21.47±6.84)d,대조조분별위24.00％(6/25)、64.00％(16/25)화(30.26±2.18)d,량조비교차이유통계학의의(P＜0.05)；관찰조1개월내MODS발생솔、병사솔、골절유합시간여대조조비교차이무통계학의의(P＞0.05).결론 조기외고정가고정적손상공제성수술치료엄중다발상병개방성경비골골절,유리우감소병발증발생,제고구치성공솔.
Objective To explore the effect of external fixation of damage control operation for treating severe multiple injury patients complicated with open tibia and fibula fractures.Methods Fiftyeight severe multiple injury patients complicated with open tibia and fibula fractures from June 2006 to February 2011 were reviewed.According to the control strategy for tibia and fibula fractures,all patients were divided into two groups:32 patients in observation group were treated with external fixation and 26 patients in control group were treated with calcaneal traction or gypsum external fixation.Wound healing time,fracture healing time,and the incidence rate of acute respiratory distress syndrome (ARDS) and multiorgan dysfunction syndrome (MODS),mortality and wound infection rate within 1 month between two groups were compared.Results In observation group,incidence of ARDS and wound infection rate within 1 month,wound healing time was 6.25％(2/32),31.25％(10/32) and (21.47 ± 6.84) d,respectively,while 24.00％(6/25),64.00％ ( 16/25 ) and (30.26 ± 2.18 ) d in control group,respectively,there were significant differences between two groups (P ＜0.05).The differences of the incidence rate of MODS and mortality within 1 month,fracture healing time of observation group were not statistically significant compared with control group (P ＞ 0.05).Conclusion External fixation of damage control operation for treating severe multiple injury patients complicated with open tibia and fibula fractures has the advantages of reducing complication occurrence and improving success rate.
