外固定支架控制性手术治疗创伤性骨折患者的临床效果研究

Study on clinical effect of controlled surgery with external fixator in the treatment of patients with traumatic fractures

目的探究外固定支架控制性手术治疗创伤性骨折患者的临床效果。方法80例创伤性骨折患者,采用扑克牌法(红桃、梅花)分为研究组(红桃)和对照组(梅花),每组40例。对照组采用切开复位内固定术治疗,研究组采用外固定支架控制性手术治疗。比较两组患者手术指标、康复指标、手术并发症发生情况、生活质量评分、治疗满意度。结果研究组切口长度(9.71±1.01)cm小于对照组的(15.46±4.12)cm,手术时间(62.20±8.47)min短于对照组的(114.39±15.22)min,术中出血量(217.28±26.45)ml少于对照组的(560.14±40.14)ml,差异均具有统计学意义(P<0.05)。研究组体温恢复时间(5.62±1.25)h、骨折愈合时间(8.73±2.41)周、凝血功能恢复时间(13.66±3.40)h均短于对照组的(12.20±2.31)h、(12.78±3.01)周、(32.04±5.60)h,差异具有统计学意义(P<0.05)。研究组发生呼吸窘迫1例(2.50%)、感染1例(2.50%)、胸膜腔积液0例、骨折不愈合1例(2.50%),对照组发生呼吸窘迫3例(7.50%)、感染3例(7.50%)、胸膜腔积液2例(5.00%)、骨折不愈合2例(5.00%)。研究组手术并发症发生率7.50%低于对照组的25.00%,差异具有统计学意义(P<0.05)。研究组心理功能评分(85.07±4.65)分、社会活动评分(87.26±5.38)分、情感评分(80.51±5.13)分、生理功能评分(85.14±6.56)分、总体健康评分(88.22±6.55)分均高于对照组的(77.28±4.36)、(77.19±4.54)、(77.37±4.28)、(79.36±4.51)、(78.84±4.33)分,差异具有统计学意义(P<0.05)。研究组总满意度95.00%高于对照组的77.50%,差异有统计学意义(P<0.05)。结论创伤性骨折患者采用外固定支架控制性手术能够有效缩短患者治疗周期,减少患者痛苦,具有较低的并发症发生率,安全性高,值得在临床中推广。

Objective To study the clinical effect of controlled surgery with external fixator in the treatment of patients with traumatic fractures.Methods A total of 80 patients with traumatic fracture were divided into a study group(hearts)and a control group(clubs)by playing cards(hearts,clubs),with 40 cases in each group.The control group was treated with open reduction and internal fixation,while the study group was treated with external fixation and controlled surgery.Both groups were compared in terms of surgical indicators,rehabilitation indicators,occurrence of surgical complications,quality of life score and treatment satisfaction.Results The incision length of(9.71±1.01)cm in the study group was shorter than that of(15.46±4.12)cm in the control group,the operative time of(62.20±8.47)min was shorter than that of(114.39±15.22)min in the control group,and the intraoperative blood loss of(217.28±26.45)ml was less than that of(560.14±40.14)ml in the control group.The differences were statistically significant(P<0.05).The study group had body temperature recovery time of(5.62±1.25)h,fracture healing time of(8.73±2.41)weeks and coagulation recovery time of(13.66±3.40)h,which were shorter than those of(12.20±2.31)h,(12.78±3.01)weeks and(32.04±5.60)h in the control group.The differences were statistically significant(P<0.05).In the study group,respiratory distress occurred in 1 case(2.50%),infection in 1 case(2.50%),pleural effusion in 0 case,fracture nonunion in 1 case(2.50%);in the control group,respiratory distress occurred in 3 cases(7.50%),infection in 3 cases(7.50%),pleural effusion in 2 cases(5.00%)and fracture nonunion in 2 cases(5.00%).The incidence of surgical complications in the study group was 7.50%,which was lower than that of 25.00%in the control group,and the difference was statistically significant(P<0.05).The scores of psychological function,social activity,emotion,physical function and overall health were(85.07±4.65),(87.26±5.38),(80.51±5.13),(85.14±6.56)and(88.22±6.55)points in the study group,which were higher than those of(77.28±4.36),(77.19±4.54),(77.37±4.28),(79.36±4.51)and(78.84±4.33)in the control group,and the differences were statistically significant(P<0.05).The total satisfaction of 95.00%in the study group was higher than that of 77.50%in the control group,and the difference was statistically significant(χ2=5.165,P<0.05).Conclusion The use of external fixators for traumatic fracture patients can effectively shorten the treatment cycle and reduce the pain of patients,and has a low complication rate and a high safety,which is worthy of clinical promotion.