红外线联合气压治疗在跟骨骨折切开复位内固定术患者围术期的应用效果研究

Perioperative Application of Infrared Therapy Combined with Air Wave Pressure Treatment on Open Reduction and Internal Fixation for Calcaneal Fracture

背景跟骨骨折切开复位内固定术围术期足踝肿胀及切口愈合一直是手术医生关注的重点,临床医生也一直在试图缩短手术等待期并降低切口感染率。目的探讨红外线联合气压治疗在跟骨骨折切开复位内固定术患者围术期应用的疗效。方法选取2016年1月-2017年1月安徽医科大学第二附属医院骨科收治的40例(40足)跟骨骨折后行切开复位内固定术患者,采用随机数字法将其分为对照组和观察组,各20例。对照组采用围术期常规康复治疗,包括:正确体位摆放、冰敷消肿、运动疗法;观察组在对照组的基础上,予以患肢红外线联合气压治疗。比较两组患者跟骨周围皮肤褶皱试验阳性所需时间、术后切口恢复情况、术后肿胀、踝周径差值、疼痛、平均住院日及住院费用情况。结果观察组跟骨周围皮肤褶皱试验转阳性所需时间为(6.4±0.7)d,短于对照组的(8.2±1.2)d(t=-5.794,P<0.001)。观察组切口治愈率为70%(14/20),高于对照组的35%(7/20)(χ^2=4.912,P=0.027)。观察组Ⅱ度肿胀发生率低于对照组(χ^2=5.584,P=0.018)。入院第5天、术后第5天,观察组踝周径差值均小于对照组(P<0.05)。入院第5天、术后第5天,观察组视觉模拟评分(VAS)均低于对照组(P<0.05)。观察组平均住院日和平均住院费用均低于对照组(P<0.05)。结论在跟骨骨折切开复位内固定术围术期应用红外线联合气压治疗,有利于消除肿胀,缓解疼痛,促进术后切口愈合,降低患者平均住院日和住院费用。

Background Open reduction and internal fixation of calcaneal fracture during the perioperative period of ankle swelling and wound healing has always been the focus of surgeons. Clinicians have also been trying to shorten the waiting period for surgery and reduce infected incision.Objective To investigate perioperative effect of infrared therapy combined with air wave pressure treatment in patients of open reduction and internal fixation for calcaneal fracture.Methods A total of 40 patients with open calcaneal fracture,who received internal fixation surgery in the Second Hospital of Anhui Medical University from January 2016 to January 2017,were randomly divided into observation group and control group,each with 20 cases.The control group was treated with perioperative routine rehabilitation,including correct posture management,ice compress and exercise therapy.The observation group had infrared therapy and air wave pressure treatment based on the treatment in control group.The time required for positive skin folding test,postoperative incision recovery,swelling,ankle circumference difference,pain,average duration of hospitalization and hospitalization expenses were compared between the two groups.Results The time needed for positive skin folding test in observation group was(6.4±0.7) days,which was lower than that in control group of(8.2±1.2)days(t=-5.794,P<0.001).The cure rate of incision in observation group was 70%(14/20),which was higher than that in control group of 35%(7/20)(χ~2=4.912,P=0.027).The incidence of grade Ⅱ swelling in observation group was lower than that in control group(χ~2=5.584,P=0.018).On the fifth day after admission and the fifth day after operation,the difference of ankle circumference in observation group was smaller than that in control group(P<0.05),and the visual analogue score(VAS) of observation group was lower than that of control group(P<0.05).The average duration of hospitalization and average expenses in observation group were less than those in control group(P<0.05).Conclusion The treatment of infrared therapy combined with air wave pressure on patients undergoing open reduction and internal fixation for calcaneal fracture has obvious curative effect on relieving swelling and pain,promoting wound healing and reducing average hospitalization duration and expenses.