CAJ | 학술논문

目的分析胫骨远端骨折内固定术后切口并发症及其相关的风险因素. 方法纳入2008年1月-2011年12月行切开复位内固定治疗的125例胫骨远端骨折患者,其中男72例,女53例;平均年龄41.46岁.对患者的人口统计学数据(年龄、性别、吸烟史)、骨折类型、手术时间、受伤至手术时间及伴发疾病(糖尿病、周围血管疾病)等变量进行评估分析.对于需要进行换药处理、口服或静脉滴注抗生素或进一步手术治疗的患者,定义为切口并发症. 结果 125例均获得随访.其中1例(0.8％)出现切口并发症需实施手术清创处理,10例(8.0％)需进行切口换药、口服或静脉滴注抗生素治疗.Logistic回归显示,开放性骨折与切口并发症之间有相关性(OR=23.077,95％CI2.672～199.342,P＜0.01);年龄与切口并发症之间有相关性(OR=1.078,95％CI1.011 ～ 1.150,P＜0.05).性别、体重指数、吸烟史、受伤至手术时间、骨折类型、是否为多发伤及手术时间长短与切口并发症之间差异无统计学意义. 结论胫骨远端骨折术后,高龄患者及开放性骨折发生切口并发症的风险大,对上述患者应做好围术期软组织管理,预防切口并发症发生.
목적 분석경골원단골절내고정술후절구병발증급기상관적풍험인소. 방법 납입2008년1월-2011년12월행절개복위내고정치료적125례경골원단골절환자,기중남72례,녀53례;평균년령41.46세.대환자적인구통계학수거(년령、성별、흡연사)、골절류형、수술시간、수상지수술시간급반발질병(당뇨병、주위혈관질병)등변량진행평고분석.대우수요진행환약처리、구복혹정맥적주항생소혹진일보수술치료적환자,정의위절구병발증. 결과 125례균획득수방.기중1례(0.8％)출현절구병발증수실시수술청창처리,10례(8.0％)수진행절구환약、구복혹정맥적주항생소치료.Logistic회귀현시,개방성골절여절구병발증지간유상관성(OR=23.077,95％CI2.672～199.342,P＜0.01);년령여절구병발증지간유상관성(OR=1.078,95％CI1.011 ～ 1.150,P＜0.05).성별、체중지수、흡연사、수상지수술시간、골절류형、시부위다발상급수술시간장단여절구병발증지간차이무통계학의의. 결론 경골원단골절술후,고령환자급개방성골절발생절구병발증적풍험대,대상술환자응주호위술기연조직관리,예방절구병발증발생.
Objective To identify risk factors for wound complications related to internal fixation of distal tibial fracture.Methods A total of 125 patients undergone open reduction and internal fixation of the distal tibial fracture between January 2008 and December 2011 were enrolled.There were 72 men and 53 women with mean age of 41.46 years.Factors contributing to operative wound complications assessed were demographic characteristics (age,gender,and smoking history),types of fracture,operative time,time from injury to operation,and concomitant diseases (diabetes and peripheral vascular disease).Patients with wound complications were defined as those requiring dressing care and oral or intravenous antibiotics or those requiring further surgical treatment.Results At follow-up,wound complications were recorded including 1 patient (0.8％) had surgical debridement and 10 patients (8.0％) had dressing care and oral or intravenous antibiotic therapy.Logistic regression analysis identified risk factors for wound complications were open fracture (OR =23.077,95％ CI 2.672-199.342,P ＜0.01) and age (OR =1.078,95％ CI 1.011-1.150,P ＜ 0.05).Otherwise,following factors exhibited no significant correlation with wound complications:age,body mass index,smoking history,types of fracture,multiple injury or not,and operative time.Conclusion Patients with older age or open fracture present an increased risk of wound complications after operation and need special concern.