罂粟碱促进跟骨骨折手术切口愈合的疗效评价

Evaluation of promotive effect on incision healing after the operation of calcaneus fractures by using papaverine

目的评价跟骨骨折术后使用罂粟碱对手术切口愈合的促进作用。方法 2010年至2013年收治的52例跟骨骨折患者按术后是否使用罂粟碱分为治疗组和对照组,治疗组29例33足,对照组23例25足。所有患者均行跟骨外侧L形切口切开复位钢板螺钉内固定术,术后常规引流片引流48 h,记录患者性别、年龄、软组织损伤程度、骨折分型、受伤到手术时间、手术时间、术中出血量、切口干燥时间、切口愈合时间、切口不健康皮缘长度、切口并发症发生率、术后1年足部功能评分等指标,并进行统计学分析。结果两组患者在性别、年龄、软组织损伤程度、骨折分型、受伤到手术时间、手术时间、术中出血量、切口并发症发生率、术后1年足部功能评分等方面差异无统计学意义。对照组切口干燥时间平均(6.2±1.9)天,平均愈合时间(17.8±3.1)天,切口健康等级优良率64.0%。治疗组切口干燥时间平均(5.1±1.2)天,平均愈合时间(15.7±2.6)天,切口健康等级优良率84.8%。两组差异有统计学意义(P分别为<0.0355、0.0063、0.0328)。结论跟骨骨折术后应用罂粟碱可促进切口愈合,减少并发症发生。

Objective To evaluate the p romotive effect on incision healing after the operation of calcaneus fractures by using papaverine. Methods From 2010 to 2013, 52 patients with calcaneus fractures were divided into 2 groups according to whether papaverine was used or not after the operation. There were 29 patients（ 33 feet） in treatment group and 23 patients（ 25 feet） in control group. All the patients underwent open reduction and internal fixation with L-type calcaneal lateral incision, and the time of regular drainage lasted for 48 hours after the operation. The clinical data were recorded in all the patients, including gender, age, degree of soft tissue injury, classification of fracture, time from injury to operation, operation time, intraoperative amount of bleeding, drying time and healing time of the incision, length of unhealthy skin and incidence of complications of the incision and function score of the foot at 1 year after the operation. Statistical analysis was performed. Results There were no statistically significant differences in gender, age, degree of soft tissue injury, classification of fracture, time from injury to operation, operation time, intraoperative amount of bleeding and function score of the foot at 1 year after the operation between the 2 groups. In control group, the average time of incision drying was（ 6.2±1.9） days and the average time of incision healing was（ 17.8±3.1） days. The good ratio of incision health degree was 64.0%. While in treatment group, the average time of incision drying was（ 5.1±1.2） days and the average time of incision healing was（ 15.7±2.6） days. The good ratio of incision health degree was 84.8%. The differences between the 2 groups were statistically significant（ P〈0.0355, 0.0063, 0.0328）. Conclusions Papaverine can promote incision heali ng and decrease complications after the operation of calcaneus fractures.