股骨干骨折患者髓内钉固定术后感染分析

Postoperative infections in femoral shaft fracture patients undergoing intramedullary nail fixation

目的探究股骨干骨折患者髓内钉固定术后发生感染性骨不连的疗效及感染控制状况,为临床防治感染提供参考。方法选取2011年6月-2014年7月医院收治的股骨干骨折髓内钉固定术后发生感染性骨不连的患者84例作为研究对象,根据患者到医院治疗的先后顺序分为观察组和对照组各42例,对照组患者采用外固定支架骨延长术方法进行治疗,观察组患者行植骨术进行治疗,比较两组患者的治疗效果及感染情况。结果观察组治疗总有效率为90.5%,明显高于对照组的78.6%,两组比较差异有统计学意义(P<0.05),观察组患者的手术时间、术中出血量、住院时间以及术后引流量均低于对照组,两组比较差异有统计学意义(P<0.05);观察组的感染程度明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论与外固定支架骨延长术相比,植骨术对于患者的治疗效果更好,患者术后的感染率更低。

OBJECTIVE To investigate the prevalence of infected nonunion in the femoral shaft fracture patients undergoing the intramedullary nail fixation and the status of control of infections so as to provide guidance for clinical prevention of the infections.METHODS A total of 84 femoral shaft fracture patients with postoperative infected nonunion who underwent the intramedullary nail fixation from Jun 2011 to Jul 2014 were recruited as the study objects and were divided into the observation group and the control group according to the order of admission to the hospital,with 42 cases in each group.The control group was treated with external fixation bone lengthening,while the observation group was treated with bone grafting.The curative effect and incidence of infections were observed and compared between the two groups of patients.RESULTS The total effective rate of treatment of the observation group was 90.5%,significantly higher than 78.6% of the control group（P〈0.05）.The operation duration,intraoperative blood loss,length of hospital stay,and postoperative drainage volume of the observation group were significently lower than those of the control group（P〈0.05）.The degrees of infections of the observation group was significantly lower than that of the control group（P〈0.05）.CONCLUSION As compared with the external fixation bone lengthening,the bone grafting may achieve better curative effect,with the incidence of postoperative infections lower.