胫腓骨开放性骨折的急诊处置及固定方式对创面感染的影响研究

Influence of emergency treatment and fixation methods of open tibia and fibula fracture on wound infection

目的研究与分析外固定支架方式以及石膏外固定方式对于治疗胫腓骨开放性骨折的临床效果以及创面感染的情况。方法从本院2013年3月～2017年3月期间内接收的胫腓骨开放性骨折患者中,随机抽取50例患者,采用随机数字表法将其分为观察组与对照组,各25例。对照组患者接受石膏外固定治疗,观察组患者接受外固定支架治疗。观察两组患者治疗后的临床效果、创面感染的几率、不良反应发生情况、疼痛情况以及手术基本情况。结果观察组患者治疗后优良率(88.00%)显著高于对照组患者(60.00%);观察组患者治疗后创面感染的几率(4.00%)显著低于对照组患者(20.00%),观察组患者总不良反应发生率(16.00%)显著低于对照组患者(52.00%);观察组患者治疗后总疼痛率(8.00%)显著低于对照组患者(40.00%);观察组患者手术时间、术中出血量、住院时间、骨折愈合时间均优于对照组患者,差异具有统计学意义(P <0.05)。结论外固定支架方法治疗胫腓骨开放性骨折效果较为显著,降低了患者创面感染的几率及不良反应的发生几率,促进了患者的恢复,利于患者早期的康复训练,临床价值较高,可以在推广使用。

Objective To study and analyze the clinical effects and wound infection of external fixation and external fixation on open tibia and fibula fractures. Methods From March 2013 to March 2017, 50 patients with open tibia and fibula fracture in our hospital were randomly selected and divided into two groups by random number table grouping method： observation group and control group, 25 cases in each group. The control group was treated with plaster external fixation, while the observation group was treated with external fixation. The clinical effect, the incidence of wound infection, the occurrence of adverse reactions, pain and the basic conditions of operation in two groups were observed. Results The excellent and good rate of the observation group（88.00%） was significantly higher than that（60.00%） of the control group after treatment. The rate of wound infection of the observation group（4.00%） was significantly lower than that（20.00%） in the control group after treatment. The incidence of total adverse reactions in the observation group（16.00%） was significantly lower than that（52.00%） in the control group. The total pain rate in the observation group（8.00%） was significantly lower than that（40.00%） in the control group after treatment. The operative time, blood loss, hospitalization time and fracture healing time in the observation group were better than those in the control group, the difference was statistically significant （P〈0.05）. Conclusion The effect of external fixation on open tibia and fibula fracture is remarkable, the incidence of wound infection and the incidence of adverse reaction are reduced, the recovery of patients is promoted, the early rehabilitation training of patients is facilitated, the clinical value is high, and can be popularized and used.