CAJ | 학술논문

目的：分析中西医结合治疗开放性胫腓骨骨折的临床效果。方法将2011年1月至2013年1月期间收治的100例开放性胫腓骨骨折患者随机分为两组，即观察组50例，对照组50例。对照组50例患者行单纯西医治疗，观察组50例患者在西医治疗的基础上行骨折初、中、后三期中医辨证治疗。采用 Johner - Wruh 评定标准分别对两组患者的临床治疗效果进行评价，观察并统计两组患者的胫骨愈合时间和腓骨愈合时间，同时观察并统计两组患者治疗后感染、骨不连、骨髓炎及筋膜间综合症等并发症的发生率。结果观察组患者临床治疗效果的优良率88.0%，明显高于对照组的64.0%，差异具有显著性（ P ﹤0.01）。观察组患者平均胫骨愈合时间、腓骨愈合时间依次为（4.66±1.24）月、（6.71±2.19）月；对照组依次为（5.88±1.28）月、（8.58±2.38）月。观察组患者骨折愈合时间优于对照组，差异具有显著性（ P ﹤0.05）。观察组患者治疗后感染、骨不连、骨髓炎及筋膜间室综合征的总发生率为10.0%；对照组为26.0%。观察组患者术后并发症发生率低于对照组，差异具有显著性（ P ﹤0.01）。结论中西医结合治疗开放性胫腓骨骨折的临床效果显著，能有效缩短患者的胫骨愈合时间和腓骨愈合时间，并降低患者治疗后并发症的发生率。
목적：분석중서의결합치료개방성경비골골절적림상효과。방법장2011년1월지2013년1월기간수치적100례개방성경비골골절환자수궤분위량조，즉관찰조50례，대조조50례。대조조50례환자행단순서의치료，관찰조50례환자재서의치료적기출상행골절초、중、후삼기중의변증치료。채용 Johner - Wruh 평정표준분별대량조환자적림상치료효과진행평개，관찰병통계량조환자적경골유합시간화비골유합시간，동시관찰병통계량조환자치료후감염、골불련、골수염급근막간종합증등병발증적발생솔。결과관찰조환자림상치료효과적우량솔88.0%，명현고우대조조적64.0%，차이구유현저성（ P ﹤0.01）。관찰조환자평균경골유합시간、비골유합시간의차위（4.66±1.24）월、（6.71±2.19）월；대조조의차위（5.88±1.28）월、（8.58±2.38）월。관찰조환자골절유합시간우우대조조，차이구유현저성（ P ﹤0.05）。관찰조환자치료후감염、골불련、골수염급근막간실종합정적총발생솔위10.0%；대조조위26.0%。관찰조환자술후병발증발생솔저우대조조，차이구유현저성（ P ﹤0.01）。결론중서의결합치료개방성경비골골절적림상효과현저，능유효축단환자적경골유합시간화비골유합시간，병강저환자치료후병발증적발생솔。
Objective To analyze the clinical effect of combined treatment in patients with open fractures of tibia and fibula by integra-tion of Chinese traditional medicine and western medicine. Methods A total of 100 cases of open fractures of tibia treated in this hospital dur-ing January 2011 to January 2013 were randomly divided into two groups,observation group(50 cases)and control group(50 cases). Fifty cases in control group were treated with simple western medicine treatment,and 50 cases in observation group were treated by western medicine and traditional Chinese medicine based on syndrome differentiation therapy. The clinical effect,observation and statistic analysis in patients of two groups were evaluated according to the criteria of Johner - Wruh with tibia and fibula including healing time,the incidence of infection,nonun-ion,osteomyelitis and compartment syndrome and other complications. Results The effective rates in patients of observation group and control group were 88. 0% and 64. 0% respectively. In comparison between these two groups,their difference was significant( P ﹤ 0. 01). The aver-age healing time of tibia and fibula in observation group was 4. 66 ± 1. 24 months and 6. 71 ± 2. 19 months respectively;and those in control group were 5. 88 ± 1. 28 months and 8. 58 ± 2. 38 months respectively. In comparison with these two groups,the difference was statistically sig-nificant( P ﹤ 0. 05). The total incidence rates of infection,nonunion,osteomyelitis and compartment syndrome in patients of observation group were all 10. 0% ;and those in control group were all 26. 0% . In comparison between two groups,the difference was significant( P ﹤ 0. 01). Conclusion The clinical effect of combined Chinese traditional medicine and western medicine in treatment of open fractures of tibia and fibula is significant,it can significantly shorten the healing time of patients with open fractures in tibia and fibula,and it also can reduce the incidence of complications in patients after treatment.