[1]王海敏,郑岚,诸葛天瑜,等.急诊清创一期骨折复位内固定对四肢开放性骨折的治疗价值[J].中国中医骨伤科杂志,2023,31(06):74-77.[doi:10.20085/j.cnki.issn1005-0205.230614]
　WANG Haimin,ZHENG Lan,ZHUGE Tianyu,et al.Retrospective Analysis of the Therapeutic Value of Emergency Debridement and One-Stage Fracture Reduction and Internal Fixation for Gustiloii Type Ⅱ Open Fractures of the Extremities[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(06):74-77.[doi:10.20085/j.cnki.issn1005-0205.230614]
点击复制

急诊清创一期骨折复位内固定对四肢开放性骨折的治疗价值()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年06期
页码:
74-77
栏目:
临床报道
出版日期:
2023-06-15

文章信息/Info

Title:
Retrospective Analysis of the Therapeutic Value of Emergency Debridement and One-Stage Fracture Reduction and Internal Fixation for Gustiloii Type Ⅱ Open Fractures of the Extremities
文章编号:
1005-0205(2023)06-0074-04
作者:
王海敏1; 郑岚1; 诸葛天瑜1; 方苏亭1△
1浙江省台州博爱医院(浙江 台州,318050)
Author(s):
WANG Haimin1; ZHENG Lan1; ZHUGE Tianyu1; FANG Suting1△
1Taizhou Boai Hospital,Taizhou 318050,Zhejiang China.
关键词:
急诊复位内固定;  负压封闭引流;  四肢开放性骨折;  清创
Keywords:
emergent reduction and internal fixation;  vacuum sealing drainage(VSD);  open fractures of the extremities;  debridement
分类号:
R683.4
DOI:
10.20085/j.cnki.issn1005-0205.230614
文献标志码:
B
摘要:
目的:探讨急诊清创一期骨折复位内固定对四肢Gustilo Ⅱ型开放性骨折中临床治疗的效果。方法:选取2018年1月至2021年6月67例Gustilo分型为Ⅱ型开放性四肢骨折患者,对其临床资料展开系统性回顾分析,患者按骨折首次手术方式分为内固定组和外固定组,分别为37例和30例。其中对外固定组行急诊清创有限内固定联合外固定二期改内固定处理,内固定组采用急诊清创一期骨折复位内固定联合负压封闭引流技术(VSD)处理,对两组临床治疗效果的优良率进行对比。结果:内固定组治疗优良率高于外固定组。结论:对于开放性四肢骨折患者而言,急诊清创一期骨折复位内固定联合应用负压封闭引流技术可以显著提高治疗效果,提高患者诊治过程的舒适度及满意度,值得在临床应用中加以推广。
Abstract:
Objective:To investigate the clinical effect of emergency debridement and one-stage fracture reduction and internal fixation on Gustilo type Ⅱ open fractures of the extremities.Methods:67 cases of Gustilo type Ⅱ open extremity fractures from January 2018 to June 2021 were selected and systematically reviewed.The first operative approach to fracture was divided into two groups,internal fixation and external fixation,with 37 and 30 patients respectively.The external fixation group received emergency debridement and limited internal fixation combined with two-stage external fixation and internal fixation.The internal fixation group received emergency debridement and one-stage fracture reduction and internal fixation combined with negative pressure vacuum sealing drainage(VSD).The recovery rates of the clinical treatment efficacy of the two groups were compared.Results:The recovery rate of treatment in the internal fixation group was higher than that in the external fixation group,and showed significant differences.Conclusion:For patients with open extremity fractures,the treatment outcomes of emergent debridement one-stage fracture reduction and internal fixation combined with VSD can significantly improve the treatment efficacy,improve the comfort and satisfaction of the patient's diagnosis and treatment process,and be worth promoting in clinical applications.

参考文献/References:

[1] 李开浪.外固定器结合封闭负压引流在四肢骨关节严重开放性骨折患者中的应用效果[J].医疗装备,2017,30(2):10-11.
[2] 李伯勋.清创指数——介绍开放性骨折新的分类方法与清创缝合处理原则[J].创伤杂志,1989,5(3):163-164.
[3] 杨敬,王强,朱伟,等.外固定架联合负压封闭引流在开放性骨折中的应用[J].中国煤炭工业医学杂志,2016,18(4):549-551.
[4] ZIRAN B H,BECHER S J.Radiographic predictors of compartment syn drome in tibial plateau fractures[J].Orthop Trauma,2013,27(11):612-615.
[5] 孟来波.交锁髓内钉内固定术与外固定支架术治疗四肢骨折的对比研究[J].临床医学,2022,42(1):74-76.
[6] 程建文,苏伟,谭桢,等.Ilizarov 外固定联合负压封闭引流修复四肢骨折合并骨筋膜室综合征[J].中国组织工程研究,2014,18(44):7162-7166.
[7] 王辉,谭家昌,杨有猛,等.负压吸引结合微创分期策略治疗胫腓骨开放性骨折[J].创伤外科杂志,2016,18(7):432-434.
[8] 谭昱,闫兆东.有限内固定结合单侧外固定支架治疗胫腓骨下端开放性骨折32例[J].中国中医骨伤科杂志,2013,11(21):45-46.
[9] 李乔,谭进红,马小明,等.锁定钢板外置与外固定支架固定骨折的生物力学研究[J].组织工程与重建外科,2015,11(5):320-322.
[10] 孙旭东,王金华,沈祥,等.外固定支架结合负压封闭引流技术在 GustiloⅢ型开放性骨折中的应用[J].安徽医学,2013,34(5):560-562.
[11] 罗忠纯,刘凯,宋春林,等.锁定钢板外置和外支架固定治疗开放性胫骨骨折的临床疗效比较[J].华西医学,2015,30(7):1213-1216.
[12] PRASARN M L,AHN J,ACHOR T S,et al.Acute compartment syndrome in patients with tibia fractures transferred for definitive fracture care[J].Am J Orthop(Belle Mead N J),2014,43(4):173-177.
[13] 张小军,李军.附带负压吸引材料的外固定钢板在四肢开放性骨折中的应用[J].创伤外科杂志,2019,21(1):36-39.
[14] 王军,鲁敏,李临齐.单侧多功能外固定支架与钢板内固定治疗开放性胫腓骨骨折的疗效比较[J].海南医学,2016,27(24):4087-4089.
[15] VALDEZ C,SCHROEDER E,AMDUR R,et al.Serum creatine kinase levels are associated with extremity compartment syndrome[J].Trauma Acute Care Surg,2013,74(2):441-445.
[16] 张丹生,李海涛,VSD 负压引流术治疗四肢创伤的临床效果[J].临床医学,2019,13(39):93-95.
[17] 王秀梅.用 VSD 负压引流技术治疗四肢创伤性软组织缺损的效果研究[J].当代医药论丛,2017,15(15):237.
[18] 郑志鹏,陈功雷,梁伟,等.VSD 负压吸引排毒术在危重型毒蛇咬伤中的临床应用[J].中华危重病急救医学,2017,29(11):1026-1029.
[19] 杜明永.封闭负压引流技术治疗四肢创伤复杂创面疗效观察[J].临床研究,2016,24(10):43.

备注/Memo

备注/Memo:
△通信作者 E-mail:fst2012@sina.com
更新日期/Last Update: 2023-06-10