闭合性跟骨骨折切口并发症的相关因素分析  

Analysis of related risk factors of incision complications after closed calcaneal fracture surgery

作　　者：陈斌[1] 孙海钰[1] 王东[1] 刘亮[1] 赵峰[1] 李渊[1] 毋斌强[1] 景英川[2] 

机构地区：[1]山西医科大学第二医院骨科第四病区,太原030001 [2]太原理工大学统计学教研室,山西省030001

出　　处：《中华临床医师杂志（电子版）》2015年第11期73-77,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的对影响跟骨骨折术后切口并发症发生的危险因素进行分析,为减少跟骨骨折术后切口并发症的发生作出参考。方法对我科116例129侧闭合性跟骨骨折患者的病例资料进行回顾性分析,对可能造成跟骨骨折术后切口并发症发生的9个危险因素进行单因素分析（骨折类型、手术时机、牵拉方法、手术时间、植骨情况、糖尿病、高血压、吸烟指数、引流方式）,对经过单因素分析有统计学意义的因素进行多因素Logistic回归分析。结果 129侧跟骨骨折术后有16例出现切口并发症,有3例伤口裂开,5例血肿形成,7例皮缘坏死,1例骨髓炎。单因素分析结果显示：切口并发症的发生组与不发生组在骨折类型、手术时机、牵拉方法、手术时间、糖尿病、高血压、吸烟指数、引流方式8个因素上的差异有统计学意义（P〈0.05）。多因素Logistic回归分析结果显示：吸烟指数（95%可信区间：1.001~4.160,P〈0.05）,手术时机的选择（95%可信区间：0.305~0.862,P〈0.05）,牵拉方法（95%可信区间：1.113~5.704,P〈0.05）,引流方式（95%可信区间：1.277~36.721,P〈0.05）是跟骨切口并发症发生的影响因素。结论禁烟,选择恰当的手术时机,术中由经过经验丰富的医师行动态牵拉,使用置管冲洗引流可能有助于减少跟骨骨折术后切口并发症的发生。Objective To analyze the related risk factors of the incision complications after closed calcaneal fracture surgery, making reference to reduce the incidence of postoperative incision complications of calcaneal fracture. Methods The medical records of 116 patients （129 calcaneal fractures） were retrospectively analyzed. The univariate analysis of nine factors （fracture type, timing of surgery, traction method, operation time, bone graft situation, diabetes, hypertension, smoking index, drainage way） that might cause complications of calcaneal incision was conducted. The multiple Logistic regression analysis was conducted for factors with statistical significance. Results Among 129 cases of calcaneal fracture, 16 involved surgical incision complications, including 3 of wound dehiscence, 7 of flap margin necrosis, 5 of hematoma, and 1 of osteomyelitis. The results of univariate analysis showed that fracture type, timing of surgery, traction method, operation time, diabetes, hypertension, smoking index, drainage way were relevant to surgical incision complications. The results of multiple Logistic regression analysis showed that smoking index, operation time, pulling method, drainage way were risk factors of calcaneal incision complications. Conclusion It is helpful for avoiding complications after calcane＇al surgeries by choose the appropriate timing of surgery, prohibiting smoking, use dynamic traction by experienced surgeons, and the use of irrigation and drainage catheter.

关 键 词：跟骨 骨折 切口 手术后并发症 回归分析 

分 类 号：R687.3[医药卫生—骨科学]