负压封闭引流术治疗胫腓骨骨折内固定术后感染疗效探讨  

Vacuum sealing drainage in treatment of infections after tibia and fibular fractures fixation

作　　者：陈桂新 

机构地区：[1]临海市第一人民医院骨科,浙江临海317000

出　　处：《中华医院感染学杂志》2013年第2期350-352,共3页Chinese Journal of Nosocomiology

摘　　要：目的比较分析持续性封闭负压引流术对于胫腓骨骨折内固定术后感染的临床疗效,为临床治疗提供依据。方法回顾性分析1999年3月-2012年3月在医院治疗的胫腓骨骨折内固定术后感染病例,其中12例采取手术清创后局部换药的治疗方式,17例患者采取手术清创后持续性封闭负压引流治疗。结果两组患者获得9～28个月(平均13个月)的随访,负压引流组患者15例获得痊愈,无1例患者需要再次手术清创,骨折平均愈合时间为5.5个月;局部换药组患者8例获得痊愈,3例患者进行再次手术清创并冲洗引流后获得临床治愈,骨折平均愈合时间为6.8个月;两组患者在感染治疗的有效率及骨折愈合时间方面差异均有统计学意义(P<0.05)。结论持续性封闭负压引流术对于胫腓骨骨折内固定术后感染的治疗具有操作简单、疗效可靠、功能恢复良好、创伤小等优点,值得在临床中广泛应用。OBJECTIVE To observe the clinical efficacy of the treatment of postoperative infection of tibia and fibular fractures by vacuum sealing drainage so as to guide the clinical treatment. METHODS Retrospective analysis of the patients with postoperative infections of tibia and fibular fractures was performed from Mar 1999 to Mar 2012, 12 cases were treated with debridement and dressing exchange, and 17 cases after internal fixation in the tibia and fibular fractures were treated with debridement lavage and vacuum sealing drainage. RESULTS During a 9-28 months-following-up （with the average of 13 months）, 15 patients were cured in the VSD group, the average fracture healing time was 5.5 months, and 8 cases were cured in the dressing exchange group, 3 patients were clinically cured through the debridement combined with the rushing and drainage, the average fracture healing time was 6.8 months. The differences in the effective rate of treatment of infections and healing time of the fractures between the two groups were statistically significant （P〈0.05）. CONCLUSION It is an effective way to treat the infections after internal fixation in the tibia and fibular fractures with debridement, with the operation simple, clinical efficacy reliable, and trauma less, which therefore is worthy of the promotion in the hospital.

关 键 词：封闭负压引流术 胫腓骨骨折 感染 

分 类 号：R181.32[医药卫生—流行病学]