八字微创切口治疗闭合跟骨骨折常见并发症及相关因素分析  

Analysis for common complications and related factors of minimally invasive internal fixation in treatment of closed calcaneal fractures

作　　者：孙昌俊[1] 毕若杰[1] 杨春燕[1] 李力更[1] 安娜[1] 周俊莲[1] 

机构地区：[1]河北省唐山市第二医院,063000

出　　处：《河北医药》2018年第1期65-68,共4页Hebei Medical Journal

基　　金：唐山市科技局计划项目(编号:15130218a)

摘　　要：目的探究闭合跟骨骨折八字微创切开内固定手术的常见并发症及相关因素分析。方法对跟骨骨折八字微创切开内固定手术的85例患者临床资料进行回顾分析,将术后并发症等级≥2分为观察组,<2分为对照组,分析并发症的危险因素。结果患者的年龄因素、吸烟史、糖尿病史、术后时机、术中皮瓣的牵拉方式、引流方式的选择,经单因素分析显示与患者术后并发症相关(P<0.05);经Logistic回归分析表明:患者年龄≥65岁、受伤至手术时间<5 d、存在长期吸烟史未戒烟(术后吸烟史或被动吸烟史)、糖尿病史、跟骨外侧皮瓣没有采用无接触牵拉技术的、术后伤足没有放置引流装置,是八字微创切开内固定跟骨闭合骨折手术后发生并发症的危险因素。结论对于闭合跟骨骨折八字微创切开内固定手术患者而言,合适的手术时机选择、术后跟骨外侧皮瓣放置引流装置、术中减少对跟骨外侧皮瓣的牵拉保护软组织血运、围手术期患者严禁吸烟,规律治疗糖尿病,以防止并发症的发生。Objective To investigate the common complications and related factors of minimal invasive internal fixation in treatment of closed calcaneal fractures. Methods The clinical data about 85 patients with closed calcaneal fractures who were treated by minimal invasive internal fixation were retrospectively analyzed. The postoperative complication grade≥ 2 was served as observation group,and which〈 2 was served as control group,then the risk factors of complications were analyzed. Results The univariate analysis showed that the patient＇s age,smoking history,history of diabetes mellitus,postoperative opportunity,Kirschner wire contactless traction technique to protect soft tissue,selection of drainage manner were closely correlated with the incidence of postoperative complications（ P 〈0. 05）. Logistic regression analysis showed that patient＇s age≥65 years,long-term smoking history,history of diabetes mellitus,the time from injury to surgery 5 d,using Kirschner wire contactless stretch technique,without putting drainage device after surgery were risk factors of incidence of postoperative complications after minimal invasive internal fixation. Conclusion For patients with closed calcaneal fractures who are ready to receive minimal invasive internal fixation,it is important to select suitable surgical opportunity,to put drainage device after operation,to protect blood supplying of soft tissue,to prohibit strictly smoking at peroperative period,to treat regularly diabetes mellitus in order to prevent the occurrence of postoperative complications.

关 键 词：跟骨骨折 手术并发症 危险因素 

分 类 号：R274.1[医药卫生—中医骨伤科学]