高压氧预处理对预防胫腓骨远端开放性骨折患者术后并发症的影响

Effects of hyperbaric oxygen preconditioning on the prevention of postoperative complications in patients with distal tibiofibular fracture

目的 探讨高压氧（hyperbaric oxygen,HBO）预处理能否降低胫腓骨远端开放性骨折患者术后并发症的发生率.方法 复旦大学附属中山医院2004年1月至2013年3月胫腓骨远端开放性骨折患者287例,经患者知情同意,签署知情同意书及医院伦理委员会批准,分为HBO预处理组149例和对照组138例,在内固定手术前常规治疗方案基础上,预处理组应用HBO治疗,对照组未实施HBO治疗,随访12 ～26个月,比较2组术后并发症发生率、功能健康水平情况.结果 预处理组术后并发症的发生率（18.8％）明显低于对照组（38.4％）,差异有统计学意义（P＜0.05）;预处理组术后功能健康水平方面优于对照组,2组差异有统计学意义（P＜0.05）.结论 术前对胫腓骨远端开放性骨折患者进行HBO预处理,能有效降低术后并发症发生率,提高术后功能健康水平.

Objective To investigate whether hyperbaric oxygen preconditioning （HBOP） could decrease the incidence of postoperative complications in patients with distal tibiofibular fracture.Methods Two hundred and eighty-seven cases of distal tibiofibular open fracture admitted into the Zhongshan Hospital Affiliated to Fudan University for treatment from January 2004 to March 2013 were randomly divided into 2 groups：the hyperbaric oxygen preconditioning （HBOP） group（n =149）and the control group（n =138）.On the basis of routine therapy prior to internal fixation,the HBOP group was administered with HBO therapy,while the control group was left there without HBO therapy.All the patents had 12-26 months of medical follow-ups to assess the results of different treatment.Then,the incidence of postoperative complications and functional recovery level were compared between the 2 groups.Results The incidence of postoperative complications in the HBOP group was obviously lower than that in the control group （P 〈 0.05）.And functional recovery level in the patients of the HBOP group was significantly superior to that of the control group,and statistical significance could be noted,when comparisons were made between the 2 groups （P 〈 O.05）.Conclusions HBO preconditioning before surgical treatment of the patients with distal tibiofibular fracture could effectively decrease the incidence of postoperative complications and improve their functional recovery level.