外固定器结合封闭负压引流术对四肢骨关节严重开放性骨折患者的治疗效果评价

Evaluation of the Therapeutic Effect of External Fixation Combined with Closed Negative Pressure Drainage on Patients with Severe Open Frac⁃tures of the Limbs and Joints

目的 探究四肢骨关节严重开放性骨折患者采取外固定器与封闭负压引流术联合治疗的临床价值。方法 本研究为病例对照研究。目的抽样法选取2021年10月—2022年12月曹县人民医院收治的78例四肢骨关节严重开放性骨折的患者,按照治疗方法不同分为对照组和观察组,各39例。两组均使用外固定器治疗,对照组结合常规引流术;观察组结合封闭负压引流术。对比两组临床疗效、康复指标、急性时相反应蛋白、并发症发生情况及疼痛评分。结果 观察组治疗总有效率为94.87%(37/39),高于对照组的76.92%(30/39),差异有统计学意义(χ^(2)=5.185,P<0.05)。观察组骨折愈合时间、创面清洁时间均短于对照组,疼痛评分低于对照组,差异有统计学意义(P均<0.05)。观察组术后1个月转铁蛋白高于对照组,触珠蛋白、铜蓝蛋白、C反应蛋白低于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 四肢骨关节严重开放性骨折患者采用外固定器联合封闭负压引流术治疗,可以提高临床疗效,降低并发症的发生率,有助于四肢骨关节严重开放性骨折患者的康复。

Objective To analyze and study the clinical effects of external fixation combined with closed negative pres-sure drainage surgery on patients with severe open fractures of the bone and joint of the limbs.Methods Seventy-eight patients suffering from severe open fractures of the bones and joints of the limbs admitted to Caoxian People′s Hospital from October 2021 to December 2022 were selected as the study object by target sampling method.Accord-ing to different treatment methods,the patients were divided into a control group and an observation group,with thirty-nine cases in each group.Both groups were treated with external fixation devices,while the control group was treated with conventional drainage surgery,observation group combined with closed negative pressure drainage surgery.Com-pare the clinical efficacy,rehabilitation indicators,acute phase response proteins,incidence of complications and pain score between two groups.Results The total effective rate of the observation group was 94.87%(37/39),which was higher than the control group′s 76.92%(30/39),and the difference was statistically significant(χ^(2)=5.185,P<0.05).The observation group had shorter fracture healing time and wound cleaning time than the control group,pain score was lower than those in the control group,and the differences were statistically significant(all P<0.05).One month af-ter surgery,the observation group had a higher level of transferrin compared to the control group,while the levels of haptoglobin,ceruloplasmin,and C-reactive protein were lower than those in the control group,the differences were statistically significant(all P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion External fixator combined with closed negative pressure drainage can improve the clinical efficacy,reduce the incidence of complications,and con-tribute to the rehabilitation of patients with severe open fractures of limbs and joints.