北京大学学报(医学版)
北京大學學報(醫學版)
북경대학학보(의학판)
Journal of Peking University (Health Sciences)
2015年
5期
791-795
,共5页
踝关节%外科手术,选择性%骨折%脱位
踝關節%外科手術,選擇性%骨摺%脫位
과관절%외과수술,선택성%골절%탈위
Ankle joint%Surgical procedures,elective%Fractures,bone%Dislocations
目的:对比踝关节骨折合并脱位急诊手术与择期手术的效果。方法:纳入2013年5月至2014年5月积水潭医院创伤骨科急诊收治并随访的踝关节骨折合并脱位的患者40例,随机分为急诊手术组和择期手术组。对两组患者的手术时间、住院天数、治疗费用、伤口愈合、Baird-Jackson功能评分及术后并发症等因素进行评价,采用独立样本t检验或卡方检验进行统计推断。结果:患者的年龄范围为19~56岁,平均年龄为(37.48±12.39)岁。40例患者中,男性28例(70.00%),女性12例(30.00%);左踝18例(45.00%),右踝22例(55.00%);后脱位17例(42.50%),外侧脱位23例(57.50%),两组患者的年龄、性别、骨折部位和骨折分型的差异均无统计学意义。两组患者的手术时间分别为(95.0±34.1) min和(100.5±32.7) min,差异无统计学意义(t=-0.516,P=0.609)。急诊手术的住院时间和住院费用均低于择期手术组(t=-5.862、t=-3.663,P<0.001、P =0.001)。利用改良的Baird-Jackson评分系统进行评分,根据最后评分分为优、良、中、差4个等级。急诊手术组中优13人(65.0%),良4人(20.0%),中3人(15.0%),差0人;择期手术组优11人(55.0%),良7人(35.0%),中2人(10.0%),差0人。总体优24人(60.0%),良11人(27.5%),中5人(12.5%),两组患者的功能评分差异无统计学意义(χ2=1.235, P=0.651)。结论:踝关节骨折合并脱位早期手术与择期手术治疗效果相比并无明显差异,但急诊手术可缩短住院天数,节省患者治疗费用。
目的:對比踝關節骨摺閤併脫位急診手術與擇期手術的效果。方法:納入2013年5月至2014年5月積水潭醫院創傷骨科急診收治併隨訪的踝關節骨摺閤併脫位的患者40例,隨機分為急診手術組和擇期手術組。對兩組患者的手術時間、住院天數、治療費用、傷口愈閤、Baird-Jackson功能評分及術後併髮癥等因素進行評價,採用獨立樣本t檢驗或卡方檢驗進行統計推斷。結果:患者的年齡範圍為19~56歲,平均年齡為(37.48±12.39)歲。40例患者中,男性28例(70.00%),女性12例(30.00%);左踝18例(45.00%),右踝22例(55.00%);後脫位17例(42.50%),外側脫位23例(57.50%),兩組患者的年齡、性彆、骨摺部位和骨摺分型的差異均無統計學意義。兩組患者的手術時間分彆為(95.0±34.1) min和(100.5±32.7) min,差異無統計學意義(t=-0.516,P=0.609)。急診手術的住院時間和住院費用均低于擇期手術組(t=-5.862、t=-3.663,P<0.001、P =0.001)。利用改良的Baird-Jackson評分繫統進行評分,根據最後評分分為優、良、中、差4箇等級。急診手術組中優13人(65.0%),良4人(20.0%),中3人(15.0%),差0人;擇期手術組優11人(55.0%),良7人(35.0%),中2人(10.0%),差0人。總體優24人(60.0%),良11人(27.5%),中5人(12.5%),兩組患者的功能評分差異無統計學意義(χ2=1.235, P=0.651)。結論:踝關節骨摺閤併脫位早期手術與擇期手術治療效果相比併無明顯差異,但急診手術可縮短住院天數,節省患者治療費用。
목적:대비과관절골절합병탈위급진수술여택기수술적효과。방법:납입2013년5월지2014년5월적수담의원창상골과급진수치병수방적과관절골절합병탈위적환자40례,수궤분위급진수술조화택기수술조。대량조환자적수술시간、주원천수、치료비용、상구유합、Baird-Jackson공능평분급술후병발증등인소진행평개,채용독립양본t검험혹잡방검험진행통계추단。결과:환자적년령범위위19~56세,평균년령위(37.48±12.39)세。40례환자중,남성28례(70.00%),녀성12례(30.00%);좌과18례(45.00%),우과22례(55.00%);후탈위17례(42.50%),외측탈위23례(57.50%),량조환자적년령、성별、골절부위화골절분형적차이균무통계학의의。량조환자적수술시간분별위(95.0±34.1) min화(100.5±32.7) min,차이무통계학의의(t=-0.516,P=0.609)。급진수술적주원시간화주원비용균저우택기수술조(t=-5.862、t=-3.663,P<0.001、P =0.001)。이용개량적Baird-Jackson평분계통진행평분,근거최후평분분위우、량、중、차4개등급。급진수술조중우13인(65.0%),량4인(20.0%),중3인(15.0%),차0인;택기수술조우11인(55.0%),량7인(35.0%),중2인(10.0%),차0인。총체우24인(60.0%),량11인(27.5%),중5인(12.5%),량조환자적공능평분차이무통계학의의(χ2=1.235, P=0.651)。결론:과관절골절합병탈위조기수술여택기수술치료효과상비병무명현차이,단급진수술가축단주원천수,절성환자치료비용。
Objective:To investigate the differences between emergency surgery and selective surgery treatment of ankle fractures with dislocation .Methods:In the study , 40 patients with ankle fracture and dislocation were treated and followed up from May 2013 to May 2014, and all the data were collected and analyzed .The subjects involved 29 male patients and 11 female patients .The patients were randomly separated into two groups , and the patients in group A were given surgical intervention within 6 hours af-ter injury , while those in group B were initially given close reduction and given selective operation when the soft tissue condition got better .Group A contained 13 male patients and 7 female patients with average age of 37.10;Group B consisted of 15 male and 5 female, with average age of 37.85.Results:The Baird-Jackson score was applied for assessment of the patients ’ outcomes.According to the score , the outcomes were classified into excellent , good, fair, and poor.In group A (emergency group), the outcomes were 13 (65.0%), 4 (20.0%), 3 (15.0%), and 0, respectively.In group B ( selective group), they were 11 (55.0%), 7 (35.0%), 2 (10.0%), and 0, respectively.The numbers of the patients from excellent to poor were 24 (55.0%), 11 (27.5%), 5 (12.5%), and 0, respectively. Conclusion: There is no significant difference in postoperative function between the two groups , however , early surgical intervention can benefit in accomplishing anatomical reduction much easier and shortening the time of hospitalization , which is cost-saving for the patients .