急診使用外固定架聯合VSD處理四肢開放性骨折效果評價

黃新華

【摘要】 目的 研究四肢開放性骨折患者在急診救治中使用外固定架聯合負壓封閉引流術（VSD）處理的效果。方法 120例四肢開放性骨折患者， 按照隨機數字表法分為實驗組與對照組， 各60例。對照組患者使用常規清創處理， 實驗組患者在對照組基礎上使用外固定架聯合VSD處理， 觀察比較兩組患者軟組織成活情況、并發癥發生情況、創面愈合時間及創面感染發生情況。結果 實驗組患者軟組織成活率為96.67%， 明顯高于對照組的75.00%， 差異具有統計學意義（P<0.05）。實驗組患者并發癥發生率為6.67%， 明顯低于對照組的20.00%， 差異具有統計學意義（P<0.05）。實驗組患者創面感染發生率為16.67%， 明顯低于對照組的56.67%， 差異具有統計學意義（P<0.05）。實驗組患者創面愈合時間為（5.82±1.56）個月， 對照組患者創面愈合時間為（7.89±2.54）個月， 實驗組患者創面愈合時間明顯短于對照組， 差異具有統計學意義（P<0.05）。結論 四肢開放性骨折患者在急診救治中使用外固定架聯合VSD處理的效果顯著， 可提高軟組織成活率， 縮短創面愈合時間， 降低并發癥發生率和創面感染發生率， 值得臨床應用。

【關鍵詞】 急診;外固定架;負壓封閉引流術;四肢開放性骨折;臨床效果

DOI：10.14163/j.cnki.11-5547/r.2019.21.006

【Abstract】 Objective? ?To study the effect of external fixator combined with vacuum sealing drainage （VSD） in emergency treatment of open fracture of extremities. Methods? ?A total of 120 patients with open fracture of extremities were divided by random number table method into experimental group and control group， with 60 cases?in each group. The control group was treated with routine debridement， and the experimental group was treated with external fixator combined with VSD on the basis of the control group. Observation and comparison were made on survival rate of soft tissue， occurrence of complications， healing time of wound and occurrence of wound infection between the two groups. Results? ?The experimental group had obviously higher survival rate of soft tissue as 96.67% than 75.00% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had obviously lower incidence of complications as 6.67% than 20.00% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had obviously lower incidence of wound infection as 16.67% than 56.67% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had wound healing time as （5.82±1.56） months， which was （7.89±2.54） months in the control group. The experimental group had obviously shorter wound healing time than the control group， and the difference was statistically significant （P<0.05）. Conclusion? ?External fixator combined with VSD is effective in emergency treatment of open fracture of extremities. It can improve the survival rate of soft tissue， shorten the time of would healing， reduce the incidence of complications and wound infection. It is worthy of clinical application.

【Key words】 Emergency; External fixator; Vacuum sealing drainage; Open fracture of extremities; Clinical effect