损伤控制理论在腓肠肌皮瓣联合外固定架在胫骨开放性骨折伴皮肤缺损患者中的应用效果  

The Application Effect of Damage Control Theory in the Gastrocnemius Muscle Flap and External Fixation of Open Tibial Fractures Combined with Skin Defects

作　　者：杨代 房波 孙书海 闫新海 兰登哲 孙同新 

机构地区：[1]山东省东营市人民医院手足外科,东营257091

出　　处：《中国现代手术学杂志》2015年第5期372-374,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探究损伤控制理论在腓肠肌皮瓣联合外固定架在胫骨开放性骨折伴皮肤缺损患者中的应用效果。方法选取我院自2011年5月至2015年5月的60例胫骨开放性骨折伴皮肤缺损患者,按伤情处理方式分为急诊手术组和损伤控制组。观察两组患者疗效、伤口愈合情况、骨折愈合时间和住院时间及并发症等,比较两组结果的差异。结果损伤控制组和急诊手术组比较,优良率为80%vs.50%(P<0.05);伤口愈合不佳率为20%vs.50%(P<0.05);愈合时间为(14.5±2.6)周vs.(15.0±2.4)周(P>0.05);平均住院时间为(26.36±2.54)d vs.(33.54±3.14)d(P<0.05),并发症发生率为10%vs.30%(P<0.05)。结论损伤控制理论在腓肠肌皮瓣联合外固定架在胫骨开放性骨折伴皮肤缺损患者的治疗中可以促进伤口愈合,减少住院时间,降低并发症且疗效显著。Objective To explore the application effect of damage control theory in gastrocnemius flap and external fixation of open tibial fractures combined with skin defects. Methods 60 cases of tibial fractures combined with skin defects were selected from our hospital in May 2011 to May 2015. According to the injury treatment,they were divided into emergency surgery group and damage control group. The efficacy of the two groups was evaluated of the wound healing time,fracture healing time,hospital stay,complications and mortality,and the results of the two groups were compared. Results The excellent rate of damage control group and the emergency surgery group was 80% and 50% respectively（ P〈0. 05）. There was 20% of poor wound healing in the damage control patients,which was better than 50% of the emergency surgery group（ P〈0. 05）.The fracture healing time was（ 14. 5 ± 2. 6） weeks vs.（ 15. 0 ± 2. 4） weeks with no significant difference（ P〉0. 05）. The average length of stay was（ 26. 36 ± 2. 54） days vs.（ 33. 54 ± 3. 14） days（ P〈0. 05） and the complication rate was10% vs. 30%（ P〈0. 05）. Conclusion Damage control theory used in the treatment of the gastrocnemius muscle flap and external fixation is effective for the patients of open tibial fractures and skin defects,with the advantages of quick wound healing,short hospital stay,and less complications.

关 键 词：损伤控制 胫骨骨折 外科皮瓣 骨折固定术 外固定器 

分 类 号：R687.3[医药卫生—骨科学]