显微外科联合Ⅰ期VSD持续引流治疗感染性长骨骨折的效果观察

Observation on effect of microsurgery combined with continuous drainage at stage Ⅰ VSD for infectious long bone fracture

目的探讨显微外科联合Ⅰ期负压封闭引流装置(VSD)持续引流治疗感染性长骨骨折的临床效果。方法选择2016年1月～2018年2月本院收治的感染性长骨骨折患者80例,按照随机数字表法分为两组,每组各40例,对照组行显微外科联合皮瓣移植手术干预,观察组实施显微外科联合Ⅰ期VSD持续冲洗治疗,比较治疗后1周机体炎症性因子变化,分析治疗过程中两组创面换药次数、创面恢复比例以及临床愈合时间,统计两组治疗期间出现的相关并发症。结果治疗后1周观察组炎症性因子肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)及超敏C反应蛋白(hs-CRP)水平均低于对照组(P <0.05),治疗期间,观察组换药次数少于对照组(P <0.05),创面恢复比例大于对照组(P <0.05),创面临床愈合时间早于对照组(P <0.05),观察组出现再发血肿、血肿、创面不愈合的整体比例显著低于对照组(P <0.05)。结论针对感染性长骨骨折患者行显微外科联合Ⅰ期VSD持续引流治疗,能有效的降低机体炎症反应,促进创面愈合,减少手术相关并发症。

Objective To investigate the effect of microsurgery combined with continuous drainage with stage I VSD for infectious long bone fracture. Methods 80 cases with infectious long bone fractures admitted to our hospital from January 2016 to February 2018 were randomly divided into an observation group and a control group,with 40 cases each group.The control group was treated microsurgery combined with flap transplantation and the observation group was given microsurgery combined with stage Ⅰ VSD continuous irrigation.The changes of inflammatory factors in the body at 1 week after treatment were compared,the number of dressing changes,the proportion of wound recovery and the clinical healing time in the two groups during the treatment were analyzed, and the related complications during the treatment in the two groups were counted. Results The levels of inflammatory factors TNF-α,IL-1 and hs-CRP in the observation group were lower than those in the control group at 1 week after treatment.The frequency of dressing change in the observation group was less than that in the control group,the proportion of wound recovery was greater than that in the control group.The clinical healing time of the wound was earlier than that in the control group,and the overall proportion of recurrent hematoma,hematoma and wound nonunion in the observation group were significantly lower than that in the control group.All the differences were statistically significant (P<0.05). Conclusion Microsurgery combined with stage Ⅰ VSD continuous drainage for patients with infectious long bone fracture can effectively reduce the body's inflammatory response,promote wound healing and reduce surgical complications.