锁骨骨折内固定术中应用可吸收止血绫的疗效研究  

Application of Absorbable Haemostat during Internal Fixation of Clavicle Fractures

作　　者：徐诣[1] 丑克[1] 何志勇[1] 邓俭良[1] 沈枫[1] 

机构地区：[1]湖南省长沙市中心医院,湖南长沙410004

出　　处：《医学临床研究》2016年第6期1054-1057,共4页Journal of Clinical Research

摘　　要：【目的】研究锁骨骨折切开复位内固定术中应用可吸收止血绫（S-100）的临床疗效。【方法】选取自2014年2月至2015年3月间本院收治的共计52例锁骨骨折患者，男38例，女14例；平均年龄44．5岁（22～78岁）。随机将患者分为试验组（采用S-100可吸收止血绫加常规方法止血）和对照组（采用常规方法止血），每组各26例。所有患者术后临床观察2周，并出院后每月复查至术后3个月。术后2周内观察愈合过程中伤13引流、分泌物细菌培养和伤口组织恢复情况，并进行肩关节Constant评分。【结果】试验组术后平均伤13引流量为（8．3±3．6）mL，明显低于对照组的（20．2±4．3）mL，差异有统计学意义（P〈0．05）。试验组手术区域周围软组织出现充血肿胀、渗出2例（7．69％），明显低于对照组的9例（34．6％），差别有统计学意义（P〈0．05）。对照组发生术后感染1例，培养出金黄色葡萄球菌，试验组未发生伤13感染；术后3个月出现颈肩部疼痛，试验组1例，对照组2例并伴僵硬。试验组肩关节Constant评分优良率分别为96．2％（25／26），但与对照组92．3％（24／26）比较差异无统计学意义（P〉0．05）。【结论】锁骨骨折内固定术中应用可吸收止血绫可减少术野渗血，避免伤口感染，并能促进伤口及周围软组织及关节功能的恢复。[ObjectiveITo explore the clinical outcomes of application of absorbable haemostat （S-100） during internal fixation of clavicle fractures. [Methods]From February 2014 to March 2015, 52 patients with different types of clavicle fractures were subjected to surgical treatment. They were 38 men and 14 women, with a mean age of 44.5 years （from 22 to 78 years）. They received internal fixation of clavicle fractures and were divided into the experimental group, which adopted S-100 absorbable haemostat and regular hemostatic measures during the surgeries, and the control group, which adopted regular hemostatic measures. By random division each group had 26 cases. The two groups were observed for 2 weeks for bleeding volume, bacterial culture of secretion, and the recovery of the wound. After leaving the hospital, the patients got back to outpatient department for checking recovery of the wound and acquired Constant score of shoulder joint function test every 4 weeks until the 12th week after operations. The two groups were not significantly different in general clinical data （ P 〉0.05）. [Results] The average drainage volume of the experimental group （8.3±2.6 mL） was significant less than that of the control group （ 20.2±4.3 mL）（ P 〈0.05）. Two patients （7.69%） of experimental group experienced congestion, swelling, and effusion of the wound in the surgical area, while nine patients（34.6% ） had similar experiences in control group; the difference between the two was significant （ P 〈0.05）. No cases of infection were found in the experimental group but one was found in the control group, and staphylococcus aureus was cultured out of the secretion. According to the outpatient checking-in after 12 weeks, there was no significant difference between the two groups in situation of soft tissue or in the good-excellent rates of Constant score （96.2% versus 92.3 % ） （ P 〉0.05）. One patient of the experimental group found continual pain in the operated shoulder and two patients

关 键 词：骨折/外科学 骨折固定术 内 止血带 可吸收性植入物 锁骨 

分 类 号：R683.411[医药卫生—骨科学]