三踝骨折围手术期应用美皮康结合“U”型抬高垫的疗效观察

Curative effect of Mepilex with U-shaped elevation pad on the perioperative period of trimalleolar fracture

目的观察三踝骨折伴张力性水泡围手术期应用美皮康结合"U"型下肢抬高垫的疗效。方法选择2015年1月至2016年9月期间广州中医药大学附属骨伤科医院运动医学科收治50例三踝骨折伴踝部张力性水泡的患者为研究对象。按随机数表法将患者分为观察组和对照组各25例,观察组患者术前踝关节张力性水泡常规消毒后用无菌注射器抽吸水泡内液和术后1周内伤口分别应用美皮康外敷结合下肢U型抬高垫护理,对照组患者踝部张力性水泡常规消毒后用无菌注射器抽吸水泡内液及术后伤口定期换药,常规护理。比较两组患者踝关节肿胀程度、等待手术时间及术后伤口愈合率和伤口感染率。结果治疗后,观察组和对照组患者的踝关节周径分别为(22.57±1.71)cm和(24.01±2.11)cm,观察组肿胀程度较对照组缓解明显,差异具有统计学意义(P<0.05);观察组和对照组的等待手术时间分别为(4.30±1.60)d和(6.80±2.40)d,观察组的等待时间较对照组明显缩短,差异具有统计学意义(P<0.05);观察组患者的伤口愈合率为100.0%,明显优于对照组的84.0%,差异具有统计学意义(P<0.05)。结论三踝骨折伴张力性水泡围手术期应用美皮康外敷结合下肢"U"型抬高垫护理,能有效改善患者术前踝关节肿胀,能缩短患者围手术期手术准备时间,降低伤口感染率,尽早恢复踝关节功能,对临床中三踝骨折伴张力性水泡患者的围手术期护理有积极的指导意义。

Objective To investigate the curative effect of Mepilex with U-shaped elevation pad for lower limbs in perioperative period of trimalleolar fracture with tension vesicle. Methods A total of 50 patients with trimalleolar fracture with tension vesicle, who admitted to Department of Sports Medicine in our hospital, were selected and divided into the observation group and the control group according to random number table, with 25 cases in each group.The patients with tension vesicle on ankle joint in the observation group were treated with sterile syringe to suck liquid in vesicle after routine disinfection, and one week after operation the wound were treated with Mepilex with U-shaped elevation pad for lower limbs. The patients with tension vesicle on ankle in the control group were treated with sterile syringe to suck liquid in vesicle after routine disinfection, and after the operation, they were given routine treatment and regular wound dressing. The swelling degree of ankle joint, waiting time for the operation, wound healing rate and wound infection rate were observed and compared between the two groups. Results After the treatment, the circumference of ankle joint of patients in the observation group and the control group were respectively（22.57 ± 1.71） cm and（24.01±2.11） cm, and the swelling degree of the observation group was significantly relieved compared with the control group（P0.05）. The waiting time for the operation of the observation group and the control group were（4.30±1.60） days and（6.80 ± 2.40） days respectively, and the waiting time of the observation group was significantly shorter than that of the control group（P0.05）. The wound healing rate was 100.0% in observation group versus 84.0% in the control group（P0.05）. Conclusion The nursing method that the patients with trimalleolar fracture with tension vesicle were treated with U-shaped elevation pad for lower limbs with Mepilex in perioperative period can effectively improve the preoperative swelling of the ankle joint, shorten the surgery preparation time, reduce the infection rate of the wound, and restore the function of ankle joint as soon as possible. It has a positive guiding significance for nursing care of the patients with trimalleolar fracture with tension vesicle in perioperative period.