多种方式联合治疗GustiloⅢC型开放性骨折并软组织损伤效果

Effect of Combined Treatment of Gustilo Type ⅢC Open Fracture with Soft Tissue Injury

目的:探究多种方式联合治疗GustiloⅢC型开放性骨折并软组织损伤效果。方法:研究对象选取江门市第二人民医院2019年6月-2020年8月收治的GustiloⅢC型开放性骨折并软组织损伤患者58例,采用随机数字法将其分为两组,对照组29例,采用常规创面处理联合内固定术治疗,观察组29例,采用负压封闭引流技术结合内固定及组织瓣移植分期联合治疗。比较两组的疗效、手术效果(手术时间、住院时间、人均清创次数、创面愈合时间),并比较两组并发症发生率。结果:观察组的治疗总有效率明显高于对照组(P<0.05);观察组的住院时间、手术时间短于对照组,人均清创次数少于对照组,创面愈合时间早于对照组(P<0.05);观察组的创面感染坏死、骨不连、气性坏疽、创面活动性出血等并发症发生率明显低于对照组(P<0.05)。结论:负压封闭引流技术结合内固定及组织瓣移植分期联合治疗GustiloⅢC型开放性骨折并软组织损伤效果显著,优于常规创面处理联合内固定术治疗,值得在临床推广。

Objective:To explore the effect of combined treatment of Gustilo typeⅢC open fracture and soft tissue injury.Method:A total of 58 patients with Gustilo typeⅢC open fracture and soft tissue injury in Jiangmen Second People’s Hospital from June 2019 to August 2020 were selected and divided into two groups according to random number.The control group(29 cases)was treated with conventional wound treatment combined with internal fixation,and the observation group(29 cases)was treated with vacuum sealing drainage combined with internal fixation and tissue flap transplantation by stages.The curative effect,operation effect(operation time,hospitalization time,debridement times per capita,wound healing time)and the incidence of complications were compared between the two groups.Result:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The hospitalization time,operation time of the observation group were shorter than those of the control group,the average debridement times was less than that of the control group,and wound healing time was earlier than that of the control group(P<0.05).The incidence of wound infection and necrosis,bone nonunion,gas gangrene and active bleeding in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Vacuum sealing drainage combined with internal fixation and tissue flap transplantation in the treatment of Gustilo typeⅢC open fracture with soft tissue injury has a significant effect,better than conventional wound treatment combined with internal fixation,and is worthy of clinical promotion.