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  • 外固定支架在Gustilo Ⅲ型胫腓骨开放性骨折分期治疗中的临床价值及对预后的影响

外固定支架在Gustilo Ⅲ型胫腓骨开放性骨折分期治疗中的临床价值及对预后的影响

作者:未知

  [摘要]目的 探讨外固定支架在Gustilo Ⅲ型胫腓骨开放性骨折分期治疗中的临床价值及对预后的影响。方法 选取2016年5月~2019年1月东莞康华医院收治的80例Gustilo Ⅲ型胫腓骨开放性骨折患者作为研究对象,按照随机数字表法将其分为对照组(40例)与观察组(40例)。对照组患者采用髓内钉治疗,观察组患者采用外固定支架法分期治疗。比较两组患者的术后踝关节功能优良率、膝关节功能优良率、愈合时间、不良反应总发生率。结果 观察组患者的愈合时间为(15.89±1.89)周,短于对照组的(30.89±3.23)周,差异有统计学意义(P<0.05)。观察组患者的不良反应总发生率为12.50%,低于对照组的35.00%,差异有统计学意义(P<0.05)。观察组患者的踝关节功能优良率为90.00%,高于对照组的65.00%,差异有统计学意义(P<0.05)。观察组患者的膝关节功能优良率为92.50%,高于对照组的60.00%,差异有统计学意义(P<0.05)。结论 在Gustilo Ⅲ型胫腓骨开放性骨折患者中采取外固定支架法分期治疗的方法能够有效提升其踝关节功能优良率、膝关节功能优良率,缩短愈合时间,并且能有效降低患者的不良反应总发生率,值得临床推广。
  [关键词]外固定支架;Gustilo Ⅲ型;开放性骨折;临床价值
  [中图分类号] R687.3          [文献标识码] A          [文章編号] 1674-4721(2019)11(a)-0123-04
  Clinical value of external fixation in the treatment of Gustilo type Ⅲ open fractures of the humerus and its influence on prognosis
  XIONG Shu-hong1   SONG Zhi-hui1   LIU Cui-ting2   CHEN Jin1   YUAN Jian-bing1   MA Jun-chang1
  1. Department of Trauma and Orthopaedics, Dongguan Kanghua Hospital, Guangdong Province, Dongguan   523000, China; 2. Department of Pharmacy, Dongguan People′s Hospital, Guangdong Province, Dongguan   523000, China
  [Abstract] Objective To investigate the clinical value of external fixation in the treatment of Gustilo type Ⅲ open fractures of the humerus and its influence on prognosis. Methods Eighty patients with Gustilo type Ⅲ open fractures of the humerus admitted to Dongguan Kanghua Hospital from May 2016 to January 2019 were enrolled in the study. They were divided into control group (40 cases) and observation group (40 cases) according to the random number table method. The patients in the control group were treated with intramedullary nails, and the patients in the observation group were treated with external fixation. The excellent rate of postoperative ankle joint function, excellent rate of knee joint function, healing time, and total incidence rate of adverse reactions were compared between the two groups. Results The healing time of the observation group was (15.89±1.89) weeks, which was shorter than that of the control group for (30.89±3.23) weeks, and the difference was statistically significant (P<0.05). The total incidence rate of adverse reactions in the observation group was 12.50%, which was lower than that in the control group (35.00%), and the difference was statistically significant (P<0.05). The excellent rate of ankle joint function in the observation group was 90.00%, which was higher than that in the control group (65.00%), and the difference was statistically significant (P<0.05). The excellent rate of knee joint function in the observation group was 92.50%, which was higher than that in the control group (60.00%), and the difference was statistically significant (P<0.05). Conclusion In the patients with Gustilo type Ⅲ open fractures of the humerus, the method of external fixation can effectively improve the excellent rate of ankle and knee joint function, shorten the healing time, and effectively reduce the total incidence rate of adverse reactions, which is worthy of clinical promotion.   近年来,在采用分期治疗的手段中[12],外固定支架在Gustilo Ⅲ型胫腓骨开放性骨折的治疗中,能有效减短患者的愈合时间,减轻了患者的负担[13]。外固定支架的优势如下:①手术属于微创型,十分利于患者的手术愈合;②手术避免了髓内钉法会对膝关节产生的伤害,极大地缩短了手术所需要的时间,同时为患者的治疗争取了先机;③降低感染的发生率[14],利于患者进行后期治疗;④缩短骨折愈合的时间,同时增强骨折愈合后的强度;⑤手术拆除简单便捷,极大地减轻了患者的负担,减轻了患者的痛苦[15-20];⑥促进愈合,同时避免手术后期并发症的发生。本研究结果显示,使用外固定支架法进行分期治疗后,观察组患者的愈合时间明显短于对照组,差异有统计学意义(P<0.05),提示使用外固定支架法进行分期治疗可以减短患者的愈合时间,并能有效避免患者出现关节僵硬等症状的发生。
  综上所述,在Gustilo Ⅲ型胫腓骨开放性骨折患者中采取外固定支架法分期治疗的方法能够有效提升其踝关节功能优良率、膝关节功能优良率,缩短愈合时间,并且能有效降低患者的不良反应总发生率,值得临床推广。
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  (收稿日期:2019-05-13  本文编辑:任秀兰)
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