[1]邵　锋,吴俊涛,王天刚,等.外固定术、封闭负压引流联合皮瓣和皮片移植治疗胫腓骨开放性骨折合并软组织缺损疗效观察[J].新乡医学院学报,2020,37(12):1161-1163.[doi:10.7683/xxyxyxb.2020.12.013]
　SHAO Feng,WU Juntao,WANG Tiangang,et al.Therapeutic effect of external fixation,vacuum sealing drainage combined with skin flap and graft transplantation on open tibia and fibula fractures combined with soft tissue defects[J].Journal of Xinxiang Medical University,2020,37(12):1161-1163.[doi:10.7683/xxyxyxb.2020.12.013]
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外固定术、封闭负压引流联合皮瓣和皮片移植治疗胫腓骨开放性骨折合并软组织缺损疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年12
页码:
1161-1163
栏目:
临床研究
出版日期:
2020-12-05

文章信息/Info

Title:
Therapeutic effect of external fixation,vacuum sealing drainage combined with skin flap and graft transplantation on open tibia and fibula fractures combined with soft tissue defects
作者:
邵　锋; 吴俊涛; 王天刚; 张春旺
（新乡医学院第三附属医院骨科，河南　新乡　453003）
Author(s):
SHAO Feng; WU Juntao; WANG Tiangang; ZHANG Chunwang
（Department of Orthopedics,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China）
关键词:
胫腓骨骨折; 软组织缺损; 皮瓣移植; 封闭负压引流; 外固定术
Keywords:
fracture of tibia and fibula; soft tissue defect; skin flap transplantation; vacuum sealing drainage; external fixation
分类号:
R683.42
DOI:
10.7683/xxyxyxb.2020.12.013
文献标志码:
A
摘要:
目的　探讨外固定术、封闭负压引流联合皮瓣、皮片移植治疗胫腓骨开放性骨折合并软组织缺损患者的临床效果。方法　选取2014年1月至2019年1月新乡医学院第三附属医院骨科收治的100例胫腓骨开放性骨折合并软组织缺损患者为研究对象，按照手术方式不同分为2组，每组50例。对照组患者采用外固定术+常规换药+二期皮瓣、皮片移植治疗，观察组患者采用外固定术+封闭负压引流+二期皮瓣、皮片移植治疗。评估2组患者术后3个月临床疗效，记录2组患者住院费用、皮瓣愈合时间及住院时间等临床指标，评估2组患者术后1 a踝关节功能评分，比较2组患者并发症发生情况。结果　观察组患者总有效率为96.0%（48/50），对照组患者总有效率为72.0%（36/50）；观察组患者总有效率显著高于对照组（P<0.05）。观察组患者住院费用、皮瓣愈合时间及住院时间均显著低于对照组（P<0.05）；观察组患者术后踝关节疼痛、功能、活动度评分均显著高于对照组（P<0.05）；观察组患者并发症总发生率低于对照组（χ2=4.396，P<0.05）。结论　采用外固定术、封闭负压引流联合皮瓣和皮片移植治疗胫腓骨开放性骨折合并软组织缺损患者效果显著，可缩短住院时间，节省医疗费用，减少并发症发生，促进踝关节功能恢复。
Abstract:
Objective　To investigate the clinical effect of external fixation,vacuum sealing drainage combined with skin flap and graft transplantation in treatment of open tibial and fibula fractures combined with soft tissue defects.Methods　One hundred patients with open tibia and fibular fracture combined with soft tissue defects who were treated in the Department of Orthopedics,the Third Affiliated Hospital of Xinxiang Medical University from January 2014 to January 2019 were selected as the research subjects,and they were divided into the control group and observation group according to different surgical methods,with 50 cases in each group.The patients in the control group were treated with external fixation + conventional dressing + two-stage skin flap and graft transplantation,and the patients in the observation group were treated with external fixation + vacuum sealing drainage + two-stage skin flap and graft transplantation.The clinical efficacy of the patients in the two groups was evaluated at three months after surgery,the clinical indicators including the hospitalization cost,healing time and hospitalization time were recorded,the ankle function of the patients in the two groups was evaluated at one year after surgery,and the complications were compared between the two groups.Results　The total effective rate in the observation group was 96.0%(48/50),the total effective rate in the control group was 72.0% (36/50)；the total effective rate in the observation group was significantly higher than that in the control group(P<0.05)；the hospitalization cost,healing time of flaps and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05)；the postoperative pain,function and activity scores in the observation group were significantly higher than those in the control group (P<0.05);the total incidence of complications in the observation group was significantly lower than that in the control group (χ2=4.396,P<0.05).Conclusion　The external fixation,vacuum sealing drainage combined with skin flap and graft transplantation have significant effect in treatment of open tibia and fibula fractures combined with soft tissue defects,which can shorten hospital stay,save medical expenses,and promote ankle joint function recovery.

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[1]黄先功,亢长江,郭建光,等.腓肠神经营养血管皮瓣修复足踝部软组织缺损18 例[J].新乡医学院学报,2006,23(05):498.

更新日期/Last Update: 2020-12-05