中国继续医学教育
中國繼續醫學教育
중국계속의학교육
CHINA CONTINUING MEDICAL EDUCATION
2015年
21期
82-84
,共3页
胫腓骨%开放性骨折%急诊清创%伤口闭合
脛腓骨%開放性骨摺%急診清創%傷口閉閤
경비골%개방성골절%급진청창%상구폐합
Tibiofibula%Open fractures%Emergency debridement%The wound closure
目的探究 Gustilo Ⅲ型胫腓骨开放性骨折急诊清创后伤口闭合的时机与方法选择。方法选取我院在2014年1月～2015年1月期间收治的 Gustilo Ⅲ型胫腓骨开放性骨折患者共42例，将其设为观察组，所有患者均进行急诊清创后骨折固定，清创后立即进行创口分泌物培养，若培养结果为阳性，则再次清创，直至培养结果为阴性时方可于<br> 48 h 后闭合伤口。选取以往我院收治的 Gustilo Ⅲ型胫腓骨开放性骨折患者共38例，这38例患者均为进行急诊清创骨折固定后常规处理闭合伤口，将其设为对照组，比较两组患者伤口的感染率和骨折愈合情况。结果观察组患者骨折固定后伤口感染率显著低于对照组，差异具有统计学意义（P ＜0.05）；观察组患者伤口愈合和骨折愈合情况均显著优于对照组，差异具有统计学意义（P ＜0.05）。结论 Gustilo Ⅲ型胫腓骨开放性骨折急诊清创后伤口闭合时机应根据伤口分泌物培养结果而定，培养结果为阴性时即可进行伤口闭合，根据软组织损伤的程<br> 48 h 后闭合伤口。选取以往我院收治的 Gustilo Ⅲ型胫腓骨开放性骨折患者共38例，这38例患者均为进行急诊清创骨折固定后常规处理闭合伤口，将其设为对照组，比较两组患者伤口的感染率和骨折愈合情况。结果观察组患者骨折固定后伤口感染率显著低于对照组，差异具有统计学意义（P ＜0.05）；观察组患者伤口愈合和骨折愈合情况均显著优于对照组，差异具有统计学意义（P ＜0.05）。结论 Gustilo Ⅲ型胫腓骨开放性骨折急诊清创后伤口闭合时机应根据伤口分泌物培养结果而定，培养结果为阴性时即可进行伤口闭合，根据软组织损伤的程<br> 度大小，选择合适的伤口闭合方式。
目的探究 Gustilo Ⅲ型脛腓骨開放性骨摺急診清創後傷口閉閤的時機與方法選擇。方法選取我院在2014年1月～2015年1月期間收治的 Gustilo Ⅲ型脛腓骨開放性骨摺患者共42例，將其設為觀察組，所有患者均進行急診清創後骨摺固定，清創後立即進行創口分泌物培養，若培養結果為暘性，則再次清創，直至培養結果為陰性時方可于<br> 48 h 後閉閤傷口。選取以往我院收治的 Gustilo Ⅲ型脛腓骨開放性骨摺患者共38例，這38例患者均為進行急診清創骨摺固定後常規處理閉閤傷口，將其設為對照組，比較兩組患者傷口的感染率和骨摺愈閤情況。結果觀察組患者骨摺固定後傷口感染率顯著低于對照組，差異具有統計學意義（P ＜0.05）；觀察組患者傷口愈閤和骨摺愈閤情況均顯著優于對照組，差異具有統計學意義（P ＜0.05）。結論 Gustilo Ⅲ型脛腓骨開放性骨摺急診清創後傷口閉閤時機應根據傷口分泌物培養結果而定，培養結果為陰性時即可進行傷口閉閤，根據軟組織損傷的程<br> 48 h 後閉閤傷口。選取以往我院收治的 Gustilo Ⅲ型脛腓骨開放性骨摺患者共38例，這38例患者均為進行急診清創骨摺固定後常規處理閉閤傷口，將其設為對照組，比較兩組患者傷口的感染率和骨摺愈閤情況。結果觀察組患者骨摺固定後傷口感染率顯著低于對照組，差異具有統計學意義（P ＜0.05）；觀察組患者傷口愈閤和骨摺愈閤情況均顯著優于對照組，差異具有統計學意義（P ＜0.05）。結論 Gustilo Ⅲ型脛腓骨開放性骨摺急診清創後傷口閉閤時機應根據傷口分泌物培養結果而定，培養結果為陰性時即可進行傷口閉閤，根據軟組織損傷的程<br> 度大小，選擇閤適的傷口閉閤方式。
목적탐구 Gustilo Ⅲ형경비골개방성골절급진청창후상구폐합적시궤여방법선택。방법선취아원재2014년1월～2015년1월기간수치적 Gustilo Ⅲ형경비골개방성골절환자공42례，장기설위관찰조，소유환자균진행급진청창후골절고정，청창후립즉진행창구분비물배양，약배양결과위양성，칙재차청창，직지배양결과위음성시방가우<br> 48 h 후폐합상구。선취이왕아원수치적 Gustilo Ⅲ형경비골개방성골절환자공38례，저38례환자균위진행급진청창골절고정후상규처리폐합상구，장기설위대조조，비교량조환자상구적감염솔화골절유합정황。결과관찰조환자골절고정후상구감염솔현저저우대조조，차이구유통계학의의（P ＜0.05）；관찰조환자상구유합화골절유합정황균현저우우대조조，차이구유통계학의의（P ＜0.05）。결론 Gustilo Ⅲ형경비골개방성골절급진청창후상구폐합시궤응근거상구분비물배양결과이정，배양결과위음성시즉가진행상구폐합，근거연조직손상적정<br> 48 h 후폐합상구。선취이왕아원수치적 Gustilo Ⅲ형경비골개방성골절환자공38례，저38례환자균위진행급진청창골절고정후상규처리폐합상구，장기설위대조조，비교량조환자상구적감염솔화골절유합정황。결과관찰조환자골절고정후상구감염솔현저저우대조조，차이구유통계학의의（P ＜0.05）；관찰조환자상구유합화골절유합정황균현저우우대조조，차이구유통계학의의（P ＜0.05）。결론 Gustilo Ⅲ형경비골개방성골절급진청창후상구폐합시궤응근거상구분비물배양결과이정，배양결과위음성시즉가진행상구폐합，근거연조직손상적정<br> 도대소，선택합괄적상구폐합방식。
Objective To explore the Gustilo Ⅲ type tibiofibula open fractures after emergency debridement in the timing of wound closure and the choice of methods. Methods Select our hospital from January 2014 to January 2015 in admitted during the period of Gustilo Ⅲ type, a total of 42 patients with tibiofibula open fractures, it is set as the observation group, all patients were performed emergency fracture fixation after debridement and wound secretion culture immediately after debridement, if the training result is positive, the debridement, again until the training results for negative when square in 48 hours after closing a wound. Select our hospital before Gustilo Ⅲ type, a total of 38 patients with tibiofibula open fractures, the prompt debridement 38 cases were fracture fixed routine treatment after closing the wound, it is set to the control group, compared two groups of patients with wound infection and fracture healing. Results The observation group of patients after fracture fixed wound infection rate was significantly lower than the control group, difference has statistical significance (P<0.05), Patients with wound healing and fracture healing of observation group were significantly better than control group, the difference is statistically significant (P<0.05).Conclusion Gustilo Ⅲ type emergency open tibiofibula fracture after debridement of the wound closure time should be according to the results of wound secretion culture, cultivate the results can be achieved when the negative for wound closure, according to the degree of injury of soft tissue, to choose the right means of wound closure.
