实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
4期
51-53
,共3页
胫腓骨开放性骨折%软组织缺损%负压封闭引流
脛腓骨開放性骨摺%軟組織缺損%負壓封閉引流
경비골개방성골절%연조직결손%부압봉폐인류
tibiofibular fractures%soft tissue injuries%vacuum sealing drainage
目的：探讨胫腓骨开放性骨折伴软组织损伤采用外固定支架联合负压封闭引流（VSD）治疗的临床效果。方法将60例胫腓骨开放性骨折伴软组织损伤患者按随机数字表法分为对照组和观察组，每组30例。对照组经清创、外固定支架术后进行传统换药治疗，观察组采用外固定支架术联合VSD治疗。所有患者均于创面新鲜后行植皮术。对2组患者术后组织缺损愈合时间、骨折愈合时间、踝关节功能恢复的优良率及并发症的发生情况进行比较。结果观察组缺损组织愈合时间、骨折愈合时间分别为（10.0±2.2）d、（5.5±1.3）个月；对照组缺损组织愈合时间、骨折愈合时间分别为（40.0±5.8）d、（8.0±2.5）个月，2组比较差异均有统计学意义（均P＜0.05）。随访10个月，观察组踝关节功能优良率明显高于对照组（93.3%比66.7%，P＜0.05）。2组均无感染、骨折移位等并发症发生。结论采用外固定支架术联合VSD治疗胫腓骨开放性骨折伴软组织损伤可充分引流，保持创面新鲜，促进创面愈合，有效地降低了感染率。
目的：探討脛腓骨開放性骨摺伴軟組織損傷採用外固定支架聯閤負壓封閉引流（VSD）治療的臨床效果。方法將60例脛腓骨開放性骨摺伴軟組織損傷患者按隨機數字錶法分為對照組和觀察組，每組30例。對照組經清創、外固定支架術後進行傳統換藥治療，觀察組採用外固定支架術聯閤VSD治療。所有患者均于創麵新鮮後行植皮術。對2組患者術後組織缺損愈閤時間、骨摺愈閤時間、踝關節功能恢複的優良率及併髮癥的髮生情況進行比較。結果觀察組缺損組織愈閤時間、骨摺愈閤時間分彆為（10.0±2.2）d、（5.5±1.3）箇月；對照組缺損組織愈閤時間、骨摺愈閤時間分彆為（40.0±5.8）d、（8.0±2.5）箇月，2組比較差異均有統計學意義（均P＜0.05）。隨訪10箇月，觀察組踝關節功能優良率明顯高于對照組（93.3%比66.7%，P＜0.05）。2組均無感染、骨摺移位等併髮癥髮生。結論採用外固定支架術聯閤VSD治療脛腓骨開放性骨摺伴軟組織損傷可充分引流，保持創麵新鮮，促進創麵愈閤，有效地降低瞭感染率。
목적：탐토경비골개방성골절반연조직손상채용외고정지가연합부압봉폐인류（VSD）치료적림상효과。방법장60례경비골개방성골절반연조직손상환자안수궤수자표법분위대조조화관찰조，매조30례。대조조경청창、외고정지가술후진행전통환약치료，관찰조채용외고정지가술연합VSD치료。소유환자균우창면신선후행식피술。대2조환자술후조직결손유합시간、골절유합시간、과관절공능회복적우량솔급병발증적발생정황진행비교。결과관찰조결손조직유합시간、골절유합시간분별위（10.0±2.2）d、（5.5±1.3）개월；대조조결손조직유합시간、골절유합시간분별위（40.0±5.8）d、（8.0±2.5）개월，2조비교차이균유통계학의의（균P＜0.05）。수방10개월，관찰조과관절공능우량솔명현고우대조조（93.3%비66.7%，P＜0.05）。2조균무감염、골절이위등병발증발생。결론채용외고정지가술연합VSD치료경비골개방성골절반연조직손상가충분인류，보지창면신선，촉진창면유합，유효지강저료감염솔。
Objective To investigate the effects of external fixation combined with vacuum sealing drainage (VSD) on open tibiofibular fractures associated with soft tissue injuries. Methods Sixty patients with open tibiofibular fractures and soft tissue injuries were randomly divided into two groups, with 30 patients in each group. Patients in control group were given traditional dressing treatment after debridement and external fixation. Patients in observation group were treated with external fixation and VSD. Skin grafting was performed after the appearance of fresh wound. Tissue defect healing time, fracture healing time,ankle function restoration exceptionol rate and complications were compared between the two groups. Results Tissue defect healing time,fracture healing time were,respectively, (10.0±2.2)days and(5.5±1.3) months in observation group, and(40.0±5.8) days and(8.0±2.5) months in control group. The differences were significant between the two groups (all P<0.05). After follow-up for 10 months, the excellent and good rate of ankle function in observation group was significantly higher than that in control group (93.3% vs 66.7%,P<0.05). No infection, fracture displacement and other complications were found in both groups. Conclusion The treatment with external fixation and VSD can provide adequate drainage,keep wound fresh,promote wound healing and reduce infection in open tibiofibular fractures associated with soft tissue injuries.
