摘要
目的探索脱氧核苷酸注射液治疗胫腓骨开放性骨折的有效性与安全性。方法2013年3月-2014年3月，入选我院72例GustiloⅡ型，Ⅲ型胫腓骨开放性骨折患者。均采用急诊清创，外固定架固定骨折，VSD技术覆盖创面后行中厚皮片植皮，患者同时给予抗感染、消肿、抗静脉血栓治疗等。治疗组36例同时给予脱氧核苷酸术中清洗治疗、VSD中冲洗治疗、同时VSD后静脉滴注，对照组给予基本的营养支持治疗。连续治疗30d后评估创面愈合、创面并发症及感染情况。结果治疗组创面完全愈合时间，骨折愈合时间（d），皮片成活面积（%）分别为27．2±13．1，55．4±17．4，99．2±1．2％。对照组分别为34．7±12．3，62．2±18．7，92．6±3．6％。另外治疗组水肿评分、疼痛评分、中重度感染，延迟愈合发生率分别为2．2±0．4，2．1±0．4，5．6％，2．8％。对照组分别为3．8±0．4，3．7±0．2，30．6％，19．4％。两组比较具有统计学差异（P〈0．05）。治疗过程中rh—aFGF主要的不良反应仅为轻度发热，因而应用过程较为安全。结论脱氧核苷酸联合VSD治疗胫腓骨开放性骨折，创面愈合更快，创面并发症更少。
Objective To explore the deoxynucleotide injection in the treatment of open fractures of tibia and fibula efficacy and safety. Methods March 2013 - 2014 in March, was selected in our hospital 72 cases GustiloⅡ type, Ⅲ open fractures of the tibia and fibula in patients with type. Adopt emergency debridement, external fixation of fracture, VSD technology in skin graft to cover the wound underwent skin graft, patients are also given anti-infection, swelling, anti-vein thrombosis treatment. Treatment group of 36 patients while giving deoxynucleotide intraoperative cleaning treatment, VSD flush treatment, while the VSD intravenous infusion, the control group was given basic nutritional support treatment. After continuous treatment 30d assess wound healing, wound complications and infection. Results The complete wound healing time, healing time （d）, skin graft survival area （%） were 27.2 ± 13.1,55.4 ± 17.4,99.2 ± 1.2%. The control group were 34.7± 12.3,62.2 ±18.7,92.6± 3.6%. Another treatment group edema score, pain score, and severe infection, delayed healing incidence of 2.2 ± 0.4,2.1 ± 0.4,5.6%, 2.g%, respectively. The control group was 3.8± 0.4,3.7± 0.2,30.6%, 19.4%. A significant difference between the two groups （P 〈0.05）. Course of treatment rh-aFGF main adverse reactions only mild fever, so the application process safer. Concusion The combined VSD deoxynucleotide open fracture of tibia and fibula, faster healing, less wound complications.
出处
《首都医药》
2014年第20期58-60,共3页
Capital Medicine
