CAJ | 학술논문

目的探讨早期(<48 h)骨折外固定术在重型颅脑创伤(GCS≤8)合并四肢骨折患者中的临床应用效果.方法统计重型颅脑创伤合并四肢骨折年龄、性别、颅脑创伤情况、骨折部位分布及其他全身情况等差异均无统计学意义的患者,根据骨折的早期(＜48 h)治疗方法不同,将重型颅脑创伤患者分为两组.A组:早期骨折外固定组(40例);B组:早期骨牵引、石膏固定等保守治疗组(57例).对比分析两组患者褥疮、肺炎、下肢静脉血栓形成等并发症发生情况,ICU时间、住院时间、骨折愈合时间、病死率等指标.结果 A组在感染率、褥疮、肺炎、下肢静脉血栓发生率方面明显低于B组(P＜0.05).A组的ICU时间、住院时间、骨折愈合时间短于B组(P＜0.05).A组的病死率低于B组,差异有统计学意义(P＜0.05).结论针对重型颅脑创伤合并四肢骨折的患者,开展早期骨折外固定法与原有早期骨牵引、石膏固定等保守治疗方法相比,减少了并发症,缩短了恢复时间,降低了病死率.
목적 탐토조기(<48 h)골절외고정술재중형로뇌창상(GCS≤8)합병사지골절환자중적림상응용효과.방법 통계중형로뇌창상합병사지골절년령、성별、로뇌창상정황、골절부위분포급기타전신정황등차이균무통계학의의적환자,근거골절적조기(＜48 h)치료방법불동,장중형로뇌창상환자분위량조.A조:조기골절외고정조(40례);B조:조기골견인、석고고정등보수치료조(57례).대비분석량조환자욕창、폐염、하지정맥혈전형성등병발증발생정황,ICU시간、주원시간、골절유합시간、병사솔등지표.결과 A조재감염솔、욕창、폐염、하지정맥혈전발생솔방면명현저우B조(P＜0.05).A조적ICU시간、주원시간、골절유합시간단우B조(P＜0.05).A조적병사솔저우B조,차이유통계학의의(P＜0.05).결론 침대중형로뇌창상합병사지골절적환자,개전조기골절외고정법여원유조기골견인、석고고정등보수치료방법상비,감소료병발증,축단료회복시간,강저료병사솔.
Objective To discuss clinical effects of early (<48 hours after injury) fraeture exter-nal fixation in treatment of severe traumatic brain injury (TBI) combined with extremity fracture. Meth-ods The study involved patients with no statistical difference in aspects of age, sex, GCS, fracture ,distri-bution and general condition. According to different treatment methods at early stage (<48 hours), the pa-tients with TBI were divided into Group A (early extremity fracture external fixation) and Group B (early extremity fracture traction or cast immobilization). A comparative observation was done on complications in-cluding bedsore, pneumonia and deep venous thrombosis and on duration in ICU, hospitalization, time for fracture healing and mortality in two groups. Results Incidence rate of bedsore, pneumonia, deep ve-nous thrombosis and mortality in Group A was lower than that in Group B (P<0.05), and Group A had shorter time for ICU, hospitalization and fracture healing (P < 0.05). Conclusion For patients with se-vere TBI combined with extremity fracture, early fracture external fixation is more effective to reduce com-plications, shorten the recovery time and reduce mortality, compared with conservative methods.