超声检查在预防胫前钝挫伤感染中的应用研究

Ultrasound in Preventing Infection of Anterior Tibia Contusion

目的研究超声检查在预防胫前钝挫伤感染中的应用价值,以达到有效控制感染的目的。方法回顾性分析我院急诊科2017年8月至2019年8月就诊的胫前软组织钝挫伤患者,共64例,在无骨折的前提下行清创处理后随机分为两组,一组1周后行胫前软组织B超检查,根据超声结果精确定位病变区域并积极处理清创引流,有效控制感染的病例进行研究;另一组1周后如无明显感染仍选择活血化瘀等治疗,后期根据患者胫前感染的情况再进行切开引流。结果胫前软组织钝挫伤的患者1周后行超声检查,可发现软组织积液、坏死,超声观察组发现积液及异常回声病变后积极切开引流,后期发生感染的几率明显低于对照组(P<0.05),且对照组在超声发现病变就切开引流的治愈时间明显短于对照组(P<0.05),因此超声观察发现异常病变后积极切开引流可明显降低后期感染率和大幅缩短组织伤口的愈合时间。结论胫前软组织钝挫伤的患者早期应用超声检查可及时发现积液、坏死和组织感染,根据超声定位早期行切开引流,清理积液及血肿、坏死组织,可有效控制感染并缩短创面的愈合时间。

Objective To study ultrasound to prevent blunt tibial contusion infection and effectively control infection.Methods From August 2017 to August 2019,64 patients with blunt anterior tibial soft tissue trauma in emergency department were retrospectively analyzed.Debridement was performed on the premise of no fracture,and then they randomly divided into two groups.After 1 week,ultrasound of anterior tibia soft tissue was performed.According to ultrasound results,lesion area was accurately located,debridement and drainage were actively processed to effectively control infection.For another group,if there was no obvious infection after 1 week,treatments such as promoting blood circulation and removing blood stasis were still selected. And then incision and drainage were performed based on anterior tibial infection.Results Patients with blunt anterior tibial soft tissue underwent ultrasound examination one week later that soft tissue effusion and necrosis were found.Ultrasound observation group found that lesions were actively incised and drained after effusion and abnormal echo,and later infection rate was significantly lower than that of control group(P<0. 05).Healing time of incision and drainage was found on ultrasound in control group was significantly shorter than that in control group(P<0. 05).Therefore,active incision and drainage after abnormal lesions could significantly reduce late infection rate and greatly shorten healing time.Conclusion Early use of ultrasound in patients with blunt anterior tibial soft tissue could detect fluid,necrosis and tissue infection.According to ultrasound positioning,early incision and drainage could be used to clear fluid,hematoma and necrotic tissue which could effectively control infection and shorten healing time.