髓腔内填塞明胶海绵减少跟骨切开复位内固定术后出血的效果评价  

Evaluation of the Effect of Gelfoam Tamponade in Reducing Postoperative Bleeding after Calcaneal Open Reduction and Internal Fixation

作　　者：徐胜余 XU Shengyu(Lanxi Hospital of Traditional Chinese Medicine,Jinhua,321102,China)

机构地区：[1]兰溪市中医院,浙江金华321102

出　　处：《金华职业技术学院学报》2024年第6期58-61,共4页Journal of Jinhua Polytechnic

基　　金：2022年度兰溪市科技局项目“明胶海绵髓腔内填塞减少Sanders Ⅲ、Ⅳ型跟骨骨折术后出血的效果评价”(序号9)。

摘　　要：目的:证实明胶海绵作为髓腔填充物的重要性体现为其能降低足跟骨切开复位内固定术后的出血量。方法:筛选出2020年1月至2023年9月间在兰溪市中医院骨伤科进行足跟骨骨折SandersⅢ、Ⅳ型切开复位内固定手术的48例患者,随机将他们分配至实验组与对照组(各24例)。对照组手术过程中未放置任何止血材料于足跟骨髓腔内,而实验组则在足跟骨髓腔内放入明胶海绵。对两组术后的出血量及伤口恢复状况进行对比观察。结果:在所有参与研究的足跟骨骨折患者中,45例在手术后伤口成功愈合并顺利出院。对照组中有2例出现皮下血肿,延后一周拆线,而实验组中有1例拆线后出现皮瓣尖部坏死,但在换药后复原。两组患者在年龄、性别以及手术时间等方面的差异无统计学意义(P>0.05),实验组的术后引流量明显小于对照组,且差异具有统计学意义(P<0.05)。结论:明胶海绵在髓腔内的使用能明显降低足跟骨切开复位内固定手术后的出血量。Objective:Confirm the importance of Gelfoam as a medullary cavity filler in reducing blood loss after open reduction and internal fixation of the heel bone.Methods:We screened 48 patients who underwent open reduction and internal fixation surgery for sanders III and IV types of calcaneal fractures between January 2020 and September 2023 in the orthopedic department of our hospital,and randomly assigned them to the experimental group versus the control group(24 patients each).No hemostatic material was used in the heel bone marrow cavity during surgery in the control group,whereas a gelatin sponge was placed in the heel bone marrow cavity in the experimental group.Postoperative blood loss and wound recovery were observed in two groups.Results:Among all the patients with calcaneal fractures who participated in the study,45 successfully healed their wounds after surgery and were discharged uneventfully.Two cases in the control group presented with subcutaneous hematoma that was pulled down a week later,while in the experimental group,one case showed necrosis in the flap tip after suture removal but recovered after dressing change.There was no significant difference between the two groups in terms of age,gender as well as operative time(P>0.05),the drainage volume after operation was significantly smaller in the experimental group than in the control group,and the difference was statistically significant(P<0.05).Conclusions:The use of Gelfoam in the medullary space can significantly reduce blood loss after open reduction and internal fixation surgery of the heel bone.

关 键 词：明胶海绵 跟骨切开复位内固定 效果评价 

分 类 号：R687.3[医药卫生—骨科学]