外固定支架固定行损伤控制性治疗在肢体、骨盆创伤骨折中的应用

Application of external fixation in injury-controlled treatment of limb and pelvic trauma fractures

目的探讨外固定支架固定行损伤控制性治疗在肢体、骨盆创伤骨折中的应用。方法选取2020年1月至2022年1月九江市第一人民医院收治的80例骨折患者作为研究对象,采用随机数字表法将其分为观察组与对照组,每组各40例。对照组患者采用传统先行石膏固定,卧床或骨牵引,后期行切开复位内固定治疗;观察组患者行外固定支架固定联合损伤控制性治疗,后期行切开复位内固定治疗。比较两组患者的手术时间、术中出血量、切口长度、手术前后的炎症因子表达水平与术后并发症总发生率。结果观察组患者的术中出血量少于对照组,手术时间及切口长度短于对照组,术后3 d的炎症因子水平低于对照组,差异有统计学意义(P<0.05)。观察组患者的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论外固定支架固定行损伤控制性治疗能缩短肢体、骨盆骨折患者的手术时间及手术切口长度,降低术中出血量,降低术后炎症因子表达水平,降低并发症发生率。

Objective To explore the application of external fixation in injury-controlled treatment of limb and pelvic trauma fractures.Methods A total of 80 fracture patients admitted to the First People′s Hospital of Jiujiang City from January 2020 to January 2022 were selected as the study subjects,and they were divided into observation group and control group by random number table method,with 40 patients in each group.The control group received traditional plaster fixation,bed rest or bone traction first,and open reduction and internal fixation later.Observation group received external fixation stent fixation combined with injury control treatment,and later received open reduction and internal fixation treatment.The operative time,intraoperative blood loss,incision length,inflammatory factor expression level before and after surgery and the total incidence of postoperative complications were compared between the two groups.Results The amount of intraoperative blood loss in the observation group was less than that in the control group,the operation time and incision length were shorter than those in the control group,and the level of inflammatory factors 3 d after surgery was lower than that in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion External fixation stent fixation and damage control treatment can shorten the operation time and length of surgical incision in patients with limb and pelvic fractures,reduce intraoperative blood loss,reduce postoperative inflammatory factor expression levels,and reduce the incidence of complications.