前列地尔联合中药预防跟骨骨折内固定术后皮肤坏死

Clinical Observation of Skin Necrosis after Internal Fixation Operation for Calcaneal Fracture and Prevention by Alprostadil Injection combined with Traditional Chinese Medicine

目的:探讨前列地尔联合中药足踝一号方预防跟骨骨折内固定术后皮肤坏死的疗效。方法:将80例Sander III、IV型跟骨骨折患者随机分为两组,均常规行锁定钢板内固定术,术后治疗组应用前列地尔静脉滴注联合口服中药(足踝一号方)治疗,对照组应用前列地尔联合七叶皂苷钠静脉滴注治疗,疗程2周,观察切口皮肤情况,并以AOFAS评分;术后随访12~36个月。结果:按AOFAS评分,治疗组优30例,良6例,可4例,优良率90%;对照组优28例,良5例,可5,差2例,优良率为82.5%。治疗组无皮肤坏死,对照组皮肤坏死3例。结论:跟骨骨折术后应用前列地尔加中药治疗,能减轻损伤皮肤肿胀,缩短围手术期时间,降低术后皮肤感染坏死等并发症。

ObjectiveTo investigate the effect of the internal fixation operation for calcaneal fracture fol-lowed by Alprostadil injection combined with Traditional Chinese Medicine.MethodsEighty patients of cal-caneal fracture with type of Sander III、IV were randomly divided into the treatment group（n=40） and the controlgroup（n=40）. Both groups had open reduction and internal fixation operation. The treatment group received Al-prostadil injection（20 μ g ＋ 100 m L NS） and Traditional Chinese Medicine, and the control group received Al-prostadil injection（20 μg＋100 m L NS） and sodium aescinate formulation injection（ 20 mg ＋100 m L NS）.Bothtwo groups were treated for two weekes.All case were followed up 12~36 months.ResultsAccording to theAOFAS scoring system, the results of the treatment group were excellent in 30 cases and good in 6cases with aexcellent rate of 90%. The results of the control group were excellent in 28 cases and good in 5 cases with a ex-cellent rate of 82.5%. The treatment group had no postoperative skin necrosis, the control group had 3 cases ofpostoperative skin necrosis with a statistically significant difference.ConclusionThe treatment of calcanealfracture with Alprostadil injection combined with Traditional Chinese Medicine is beneficial in relieving skinswelling, shortening perioperative period and reducing skin necrosis.