四联疗法在Pilon骨折术后应用效果分析

Analysis of the effect of quadruple therapy after Pilon fracture operation

目的研究加压包扎、冷敷、石膏外固定、抬高患肢四联疗法在Pilon骨折术后应用效果。方法收集2010年2月至2018年2月我科收治的Pilon骨折患者125例,均行手术内固定。术后随机分为4组,观察组(n=32),采用加压包扎+冷敷+石膏外固定+抬高患肢四联疗法治疗;对照1组(n=31),采用加压包扎+冰块冷敷+抬高患肢治疗;对照2组(n=31),采用石膏外固定+冰块冷敷+抬高患肢治疗;对照3组(n=31),采用冰块冷敷+抬高患肢治疗。比较各组术后VAS评分、患肢肿胀情况、并发症发生情况及患者满意度。结果术后VAS评分观察组优于所有对照组,差异均有统计学意义(P<0.01);对照1组与对照2组比较差异无统计学意义(P>0.05)。观察组术后踝围差值与对照1组之间比较无统计学意义(P>0.05);观察组踝围差值低于对照2组及对照3组,差异均有统计学意义(P<0.01)。观察组的并发症发生率明显低于所有对照组,差异均具有统计学意义(P<0.01);对照1组与对照2组比较无统计学差异(P>0.05)。观察组满意度高于所有对照组,差异均有统计学意义(P<0.01);对照1组与对照2组之间比较无统计学差异(P>0.05)。结论Pilon骨折术后四联疗法综合治疗具有显著的临床效果。

Objective To study the effect of compression bandage,cold compress,plaster external fixation and elevation of the affected limb in the treatment of Pilon fracture.Methods Totally 125 cases with Pilon fracture were collected from February 2010 to February 2018,which were treated with internal fixation.The patients were randomly divided into four groups:the observation group(n=32),treated with compression bandage,cold compress,plaster external fixation and elevation of the affected limb;the control group 1(n=31),treated with compression bandage,cold compress and elevation of the affected limb;the control group 2(n=31),treated with plaster external fixation,cold compress and elevation of the affected limb;the control group 3(n=31),treated with cold compress and elevation of the affected limb.The VAS score,swelling,complications and patients'satisfaction were compared.Results The VAS score of the observation group was better than that of the control group(P<0.01),and there was no significant difference between the control group 1 and the control group 2(P>0.05).There was no significant difference between the observation group and the control group 1(P>0.05),the ankle circumference difference in the observation group was lower than that in control group 2 and control group 3,and the difference was statistically significant(P<0.01).The incidence of complications in the observation group was significantly lower than that in all the control groups,and the difference was statistically significant(P<0.01);there was no statistical difference between control group 1 and control group 2(P>0.05).The satisfaction of the observation group was higher than that of all the control groups,and the difference was statistically significant(P<0.01);there was no statistically significant difference between control group 1 and control group 2(P>0.05).Conclusion The combined treatment of Pilon fracture with quadruple therapy has significant clinical effect.