负压封闭引流术联合肌皮瓣移植治疗胫骨开放性骨折并发慢性骨髓炎的疗效观察  

Effect of Vaccum Sealing Drainage Combined with Muscle Flap Transplantation on Open Tibial Fractures Complicated with Chronic Osteomyelitis

作　　者：陆晓生[1,2] 黄湄景 华树良[1,2] 

机构地区：[1]右江民族医学院附属西南医院 [2]百色市人民医院骨科,百色市533000 [3]广西百色市民族卫生学校外科教研室,百色市533000

出　　处：《广西医学》2014年第3期306-308,共3页Guangxi Medical Journal

基　　金：广西百色市科学研究与技术开发计划项目(0908026)

摘　　要：目的比较负压封闭引流术联合肌皮瓣移植与传统方法治疗胫骨开放性骨折并发慢性骨髓炎的效果,为临床治疗提供参考。方法胫骨开放性骨折并发慢性骨髓炎患者73例,按随机数字表法分为负压封闭引流术组(A组)38例和常规换药组(B组)35例。A组采用负压封闭引流术联合肌皮瓣移植治疗,B组采用传统换药皮瓣移植术治疗。比较两组的愈合率、愈合时间、医疗费用、感染性皮瓣坏死发生率、剧烈疼痛持续时间、患者满意率、踝关节僵硬发生率等指标。结果 A组患者愈合率、满意率均高于B组(P<0.05),感染性皮瓣坏死发生率、踝关节僵硬等发生率均低于B组(P<0.05),愈合时间、剧烈疼痛持续时间等均短于B组(P<0.05),两组的医疗费用差异无统计学意义(P>0.05)。结论负压封闭引流术结合肌皮瓣转位具有愈合率高、愈合快、痛苦小、并发症少、患者满意率高等优点。Objective To compare the therapeutic effect of vaccum sealing drainage combined with muscle flap transplantation versus traditional methods on open tibial fractures complicated with chronic osteomyelitis ,and to provide some references for the clinical treatment .Methods Seventy-three cases of open tibial fractures complicated with chronic osteomyelitis were divided into two groups according the random number table ,with 38 cases in the vaccum sealing drainage group（group A） and 35 cases in conventional debridement dressing group （group B）.The patients in group A were treated with vaccum sealing drainage combined with muscle flap transplantation while in group B were treated with conventional debridement and dressing plus flap transplantation .The indexes including healing rate ,healing time,total medical costs , incidence of skin flap necrosis for infection ,duration of acute pain ,patient satisfaction rate and incidence of ankle joint stiffness were compared between two groups .Results The healing rate ,patient satisfaction rate of group A were higher than those of group B（P〈0.05）.The incidence of skin flap necrosis for infection and incidence of ankle joint stiffness of group A were lower than those of group B （P〈0.05）.The healing time and duration of acute pain of group A were less than those of group B （ P〈0 .05 ） .There was no significant difference in total medical costs between two groups （ P〉0 .05 ） .Conclusion The vaccum sealing drainage combined with muscle flap transplantation has the advantages of high healing rate ,fast healing ,less pain ,less complications and higher patient satisfaction rate .

关 键 词：胫骨骨折 负压封闭引流 肌皮瓣移植 慢性骨髓炎 开放性骨折 

分 类 号：R473.6[医药卫生—护理学]