可吸收止血材料在髋臼锉髂骨取骨术中应用效果  

Application of absorbable hemostatic material in the operation of iliac osteotomy using absorbable hemostatic material

作　　者：纪振钢 韩天宇 周大鹏 张昊 刘宝军 罗健楠 JI Zhen-gang;HAN Tian-yu;ZHOU Da-peng;ZHANG Hao;LIU Bao-jun;LUO Jian-nan(Department of Orthopaedics,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院骨科,辽宁沈阳110016 [2]北部战区总医院医务部,辽宁沈阳110016

出　　处：《临床军医杂志》2019年第11期1167-1169,共3页Clinical Journal of Medical Officers

基　　金：国家科技重大专项子课题(2016ZX09J16103);全军重大课题(AWS14C003);辽宁省自然科学基金(201602770)

摘　　要：目的探讨在髋臼锉髂骨取骨术中使用可吸收止血材料的可行性与安全性。方法选取自2012年1月至2018年9月北部战区总医院收治的43例外伤性长骨骨缺损患者为研究对象,均采用Masquelet膜诱导技术分期治疗,骨缺损植骨采用髋臼锉髂骨取骨术。根据术中使用止血材料的不同将患者分为观察组(n=24)与常规组(n=19)。观察组采用可吸收止血材料止血,常规组进行常规止血。比较两组患者术后的髂骨引流量、周围软组织充血肿胀渗出情况及并发感染情况,采用Paley骨折愈合评分标准和X线影像判定治疗效果。结果 43例患者术后均获得7~36个月随访,平均14.8个月。按Paley骨折愈合评分标准进行评价,观察组优良率为87.5%(21/24),常规组优良率为84.2%(16/19),两组比较,差异无统计学意义(P>0.05)。观察组平均引流量、肿胀渗出发生率均低于常规组,差异有统计学意义(P<0.05)。两组并发感染的发生率比较,差异无统计学意义(P>0.05)。结论在髋臼锉髂骨取骨术中应用可吸收性止血材料具有手术创面止血效果好、减少渗液的作用,使用安全、方便。Objective To evaluate clinical efficacy of absorbable hemostatic material in the operation of iliac osteotomy using absorbable hemostatic material.Methods A retrospective study was performed on 43 cases of patients with traumatic long bone defect who were admitted from January 2012 to September 2018.Masquelet membrane induction technique was used for staging treatment of bone defects,and acetabular filing of iliac bone was used for bone grafting.Patients were divided into the observation group(n=24)and the conventional group(n=19)according to the hemostatic materials used during the operation.Absorbable hemostatic materials were used in the observation group and routine hemostasis was performed in the conventional group.Paley fracture healing score and X-ray image were used to determine the treatment effect.Results All 43 patients were followed up for 7 to 36 months,with an average of 14.8 months.According to Paley fracture healing score,the excellent and good rate was 87.5%(21/24)in the observation group and 84.2%(16/19)in the conventional group,and the difference between the two groups was not statistically significant(P>0.05).The average drainage volume and the incidence of swelling and exudation in the observation group were lower than those in the conventional group(P<0.05).There was no significant difference in the incidence of concurrent infection between the two groups(P>0.05).Conclusion Absorbable hemostatic material applied in iliac osteotomy operation had satisfactory effects of hemostasis and reducing the raw surface effusion,and it was safe and convenient.

关 键 词：骨缺损 重建 可吸收止血材料 髂骨取骨术 

分 类 号：R687.3[医药卫生—骨科学]