外固定器联合VSD治疗胫腓骨骨折患者术后感染的效果观察(1)
[摘要]目的 研究外固定器联合负压封闭引流技术(VSD)治疗胫腓骨骨折(TFF)患者术后感染的效果。方法 将我院2013年5月～2015年11月收治的70例TFF患者随机分为观察组和对照组各35例，观察组患者采用外固定器联合VSD治疗，对照组患者采用外固定器联合传统持续灌注冲洗治疗。比较两组治疗效果。结果 观察组患者治疗后感染控制时间、换药次数、缺损组织愈合时间、骨折愈合时间、疼痛评分及住院时间均显著低于对照组(P<0.01)；观察组患者治疗总有效率为94.29%，显著高于对照组(71.43%)(P<0.05)；观察组患者治疗后生理功能、生理职能、躯体疼痛、社会功能、精神健康、情感职能、活力、一般健康状况积分均显著高于对照组(P<0.01)；观察组患者治疗后并发症发生率(11.43%)显著低于对照组(37.14%)(P<0.05)。结论 外固定器联合VSD治疗TFF患者术后感染可促进患者术后恢复，效果明显，安全性好，患者生存质量明显提高，值得临床推广应用。
[关键词]外固定器；负压封闭引流技术；胫腓骨骨折；感染
[中图分类号]R687.3 [文献标识码]A [文章编号]1674-4721(2016)06(a)-0080-03
[Abstract]Objective To explore the effect of external fixator combined with vacuum sealing drainage (VSD) in treatment of postoperative infection in tibiofibular fracture (TFF).Methods 70 TFF patients treated in our hospital from May 2013 to November 2015 were randomly and equally divided into observation group and control group.Patients in the observation group were given external fixator combined with VSD，while patients in the control group were given external fixator combined with conventional perfusion and irrigation.The effect in two groups was compared.Results The time to infection control，times of dressing change，time to defect healing，time to fracture healing，pain scores，and hospital stay were significantly shorter/lower in the observation group than those in the control group (P<0.01).The overall response rate was 94.29% in the observation group，which was significantly higher than 71.43% in the control group (P<0.05).The scores of physical function，physical role，body pain，social function，mental health，emotional role，vitality，and general health condition were all significantly higher in the observation group than those in the control group (P<0.01).The incidence rate of complications was 11.43% in the observation group，significantly lower than 37.14% in the control group (P<0.05).Conclusion External fixator combined with VSD in treatment of TFF postoperative infection can promote recovery of patients after operation with evident effects and safety，and can significantly improve the life quality of patients，thus is worthy to be promoted.
[Key words]External fixator；Vacuum sealing drainage；Tibiofibular fracture；Infection
胫腓骨骨折(TFF)由于特殊的解剖结构影响，常伴有粉碎与骨缺失、创面软组织、血管及神经损伤严重，早期治疗不当常导致皮肤坏死、创口感染、骨和内固定外露、骨髓炎等严重并发症[1-3]。外固定器固定操作简单、创伤小、可随时调节力度，有利于患者术后功能锻炼，外固定器联合负压封闭引流技术(VSD)在临床上用于治疗软组织损伤效果显著，术后感染率低[4]。本文旨在研究外固定器联合VSD对胫腓骨骨折患者术后感染的控制效果。
1资料与方法
1.1一般资料
选取我院2013年5月～2015年11月收治的TFF术后感染患者70例，男53例，女17例，年龄21～69岁，平均(41.7±5.2)岁；发生感染时间18～35 d，平均(21.6±3.3)d；致伤原因：车祸伤31例，重物挤压伤15例，高空坠落伤12例，击打伤12例；骨折类型：闭合性骨折31例，开放性骨折39例。排除陈旧性、病理性骨折、既往有胫骨手术史者及骨折前不具有活动能力者。将患者按照随机数字表法分为观察组和对照组各35例，两组患者一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (陈武生 王锡奕 许镇文)
[关键词]外固定器；负压封闭引流技术；胫腓骨骨折；感染
[中图分类号]R687.3 [文献标识码]A [文章编号]1674-4721(2016)06(a)-0080-03
[Abstract]Objective To explore the effect of external fixator combined with vacuum sealing drainage (VSD) in treatment of postoperative infection in tibiofibular fracture (TFF).Methods 70 TFF patients treated in our hospital from May 2013 to November 2015 were randomly and equally divided into observation group and control group.Patients in the observation group were given external fixator combined with VSD，while patients in the control group were given external fixator combined with conventional perfusion and irrigation.The effect in two groups was compared.Results The time to infection control，times of dressing change，time to defect healing，time to fracture healing，pain scores，and hospital stay were significantly shorter/lower in the observation group than those in the control group (P<0.01).The overall response rate was 94.29% in the observation group，which was significantly higher than 71.43% in the control group (P<0.05).The scores of physical function，physical role，body pain，social function，mental health，emotional role，vitality，and general health condition were all significantly higher in the observation group than those in the control group (P<0.01).The incidence rate of complications was 11.43% in the observation group，significantly lower than 37.14% in the control group (P<0.05).Conclusion External fixator combined with VSD in treatment of TFF postoperative infection can promote recovery of patients after operation with evident effects and safety，and can significantly improve the life quality of patients，thus is worthy to be promoted.
[Key words]External fixator；Vacuum sealing drainage；Tibiofibular fracture；Infection
胫腓骨骨折(TFF)由于特殊的解剖结构影响，常伴有粉碎与骨缺失、创面软组织、血管及神经损伤严重，早期治疗不当常导致皮肤坏死、创口感染、骨和内固定外露、骨髓炎等严重并发症[1-3]。外固定器固定操作简单、创伤小、可随时调节力度，有利于患者术后功能锻炼，外固定器联合负压封闭引流技术(VSD)在临床上用于治疗软组织损伤效果显著，术后感染率低[4]。本文旨在研究外固定器联合VSD对胫腓骨骨折患者术后感染的控制效果。
1资料与方法
1.1一般资料
选取我院2013年5月～2015年11月收治的TFF术后感染患者70例，男53例，女17例，年龄21～69岁，平均(41.7±5.2)岁；发生感染时间18～35 d，平均(21.6±3.3)d；致伤原因：车祸伤31例，重物挤压伤15例，高空坠落伤12例，击打伤12例；骨折类型：闭合性骨折31例，开放性骨折39例。排除陈旧性、病理性骨折、既往有胫骨手术史者及骨折前不具有活动能力者。将患者按照随机数字表法分为观察组和对照组各35例，两组患者一般资料比较，差异无统计学意义(P>0.05)，具有可比性。 (陈武生 王锡奕 许镇文)