负压封闭引流联合一期内固定治疗严重软组织缺损下肢开放性骨折的临床研究

Clinical Research on Vacuum Sealing Drainage Combined with Stage One Internal Fixation as Treatment for Severe Soft Tissue Defects of Lower Extremity Open Fractures

目的对比探讨负压封闭引流联合一期内固定治疗严重软组织缺损下肢开放性骨折的方法及临床疗效。方法选取第三军医大学附属新桥医院近期确诊收治的70例严重软组织缺损下肢开放性骨折患者分为两组,其中对照组32例仅行一期内固定联合传统敷料覆盖术,治疗组38例联合负压封闭引流,随访期间对比两组患者的创面愈合率及时间、临床疗效(优良率)及Frankel分级变化。结果治疗后,所有患者的Frankel分级均优于治疗前(P<0.05),而两组间相比,治疗组的Frankel分级、临床疗效及临床指标均优于对照组(P<0.05)。结论采用负压封闭引流联合一期内固定治疗严重软组织缺损下肢开放性骨折,符合生物力学特征,可有效地改善患者的临床症状及体征,且安全性高,值得推广。

Objective To compare vacuum-assisted closure drainage combined with stage one internal fixation as treatment for severe soft tissue defect of lower limb open＇fractures and the clinical efficacy. Meth- ods 70 cases diagnosed as severe soft tissue defects of lower limb open fractures admitted by Third Military Medical University Affiliated Xinqiao Hospital recently were divided into two groups ,32 cases in the control group received only stage one internal fixation combined with traditional dressing; 38 cases in the treatment groupreceived combined vacuum-assisted sealing drainage;the wound healing rate and time, the clinical effi- cacy（ excellent rates）and Frankel grade changes of the＇ two groups during the follow-up were compared. Re- suits Frankel grade after treatment of all patients were better than beforethe treatment （ P 〈 O. 05 ）, and the Frankel grade,clinical efficacy and clinical parameters of the treatment group were all better than the control group （ P 〈 0.05 ）. Conclusion The vacuum sealing drainage combined with stage one internal fixation as treatment for severe soft tissue defects of lower extremity open fractures, in line with the biomechanlcal char- acterlstics,which can effectively improve the clinical symptoms and signs,is safe and worth promoting.