跟骨骨折内固定术切口体表温度极端值与切口不愈合的相关性分析  

Analysis of the correlation between the extreme temperature of incision surface and non-union of incision in internal fixation of calcaneal fracture

出　　处：《中国基层医药》2019年第19期2305-2309,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划项目(2017KY631).

摘　　要：目的探讨跟骨骨折切开复位内固定术切口体表温度的极端值与切口不愈合结局的相关性。方法观察温州市中西医结合医院创伤骨科2016年1月至2017年12月收治的跟骨骨折切开复位内固定术患者142例,术后间断以红外测温仪测量切口体表温度4~5次,将多次测量结果的极低值和极高值纳入分析;随访终点定义为术后第14天的切口愈合情况,并因此分为切口愈合组和切口不愈合组;登记年龄、性别、炎症相关指标、血红蛋白量、体质量指数、相关病史等因素进行相关性分析。结果全部患者完成了术后14 d的随访观察,最终达到切口愈合患者累计105例;切口不愈合患者累计37例。切口不愈合组切口体表温度极低值为(34.13±0.60)℃,低于愈合组的(34.91±0.47)℃(t=7.152,P=0.000);不愈合组极高值为(36.90±0.52)℃,高于愈合组的(36.61±0.55)℃(t=-2.762,P=0.007)。Logistic回归分析发现年龄[β(回归系数)=-0.111]、切口体表温度的极高值(β=2.728)或极低值(β=-3.854)、动脉硬化(β=4.597)、糖尿病史(β=2.234)是发生切口不愈合的危险因素(P=0.046、0.003、0.001、0.002、0.024)。结论术后观察到切口体表温度极端值(过高或过低),是跟骨骨折切开复位内固定术后发生切口不愈合的危险因素。Objective To explore the correlation between the extreme temperature of incision surface and non-union of incision in internal fixation of calcaneal fracture. Methods From January 2016 to December 2017, 142 patients with closed unilateral calcaneal fracture treated with open reduction and internal fixation in the Integrated Chinese and Western Medicine Hospital of Wenzhou were enrolled.The incision temperature was collected by infrared radiation thermometers intermittently for 4-5 times, and the extreme values were used for further analysis.The primary endpoint of the study was the incision healing 14 days after surgeries.The patients′ age, gender, inflammatory indicators and body mass index (BMI) were evaluated, as well as related factors such as diabetes and arteriosclerosis. Results All patients completed the follow-up observation 14 days after operation, and finally achieved the wound healing in 105 cases, and the wound non-healing in 37 cases.The average extreme value of low temperature was (34.91±0.47)℃ in the union group and (34.13±0.60)℃ in the disunion group, and the average extreme value of high temperature was (36.61±0.55)℃ in the union group and (36.90±0.52)℃ in the disunion group, there were statistically significant differences between the two groups(t=7.152,-2.762, P=0.000, 0.007). Logistic regression analysis results showed that age[β(regression coefficient)=-0.111], extreme high(β=2.728) or very low (β=-3.854), arteriosclerosis(β=4.597), history of diabetes(β=2.234) were risk factors for incision nonunion(P=0.046, 0.003, 0.001, 0.002, 0.024). Conclusion Extreme incision temperature is observed to be associated with an increased risk of operative incision disunion after open reduction and internal fixation for calcaneal fractures.

关 键 词：骨折 跟骨 骨折固定术 内 体温 伤口愈合 手术后并发症 LOGISTIC模型 

分 类 号：R687.3[医药卫生—骨科学]