复合负压吸引的外固定钢板治疗四肢开放性骨折患者的效果及对炎症指标、肢体功能的影响

Effect of external fixation plate combined with negative pressure suction in the treatment of patients with open fracture of extremities and its influences on inflammation index and limb function

目的分析复合负压吸引的外固定钢板治疗四肢开放性骨折患者的效果。方法选取2020年6月至2021年12月收治的82例四肢开放性骨折患者作为研究对象,按随机数字表法将其分为对照组和观察组,各41例。对照组采用外固定结合负压封闭引流(VSD)治疗,观察组采用复合负压吸引的外固定钢板治疗。比较两组的治疗效果。结果观察组的创口甲级愈合率、骨折愈合优良率高于对照组(P<0.05)。观察组的换药次数、创口愈合时间、骨折愈合时间、住院时间及术后7 d的视觉模拟量表(VAS)评分均优于对照组(P<0.05)。术后7 d,两组的降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及基质细胞衍生因子-1(SDF-1)水平均降低,且观察组低于对照组(P<0.05)。术后3个月,两组的简易Fugl-Meyer运动功能评价量表(FMA)及四肢活动评分均高于术后1个月(P<0.05);术后3个月,两组的FMA及四肢活动评分无显著差异(P>0.05)。结论复合负压吸引的外固定钢板治疗四肢开放性骨折能促进创面和骨折愈合,加快康复进程,减轻炎症反应,且有利于肢体功能恢复。

Objective To analyze the effect of external fixation plate combined with negative pressure suction in the treatment of patients with open fracture of extremities.Methods A total of 82 patients with open fracture of extremities admitted from June 2020 to December 2021 were selected as the research objects and divided into control group and observation group according to the random number table method,with 41 cases in each group.The control group was treated with external fixation combined with vacuum sealing drainage(VSD),and the observation group was treated with external fixation plate combined with negative pressure suction.The therapeutic effects of the two groups were compared.Results The grade A healing rate of wound and excellent and good rate of fracture healing in the observation group were higher than those in the control group(P<0.05).The frequency of dressing change,wound healing time,fracture healing time,hospitalization time and Visual Analogue Scale(VAS)score at 7 d after operation in the observation group were better than those in the control group(P<0.05).At 7 d after operation,the levels of procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and stromal cell-derived factor-1(SDF-1)in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).At 3 months after operation,the simple Fugl-Meyer Motor Assessment(FMA)and limb activity scores of the two groups were higher than those at 1 month after operation(P<0.05);at 3 months after operation,there were no significant differences in FMA and limb activity scores between the two groups(P>0.05).Conclusion The external fixation plate combined with negative pressure suction in the treatment of open fracture of extremities can promote wound and fracture healing,accelerate the rehabilitation process,and reduce the inflammatory response,which is conducive to the recovery of limb function.