摘要
目的 探讨胫腓骨骨折合并软组织严重损伤的有效途径。方法 回顾性分析2003年5月～2005年10月收治的49例胫腓骨骨折患者的临床资料。在急诊单侧多功能为固定架固定术后即应用下列抗氧化剂治疗：①20％甘露醇250ml，30分钟内静脉滴完，6h或8h一次。七叶皂甘钠20mg加入5％GS 250ml中静脉滴注，每天一次。上述两种药物连续应用5～7天。②丹参注射液20ml加入5％GS或生理盐水250ml中静脉滴注，每天一次，连续应用2周。早期维持液体轻度负平衡及电解质平衡，预防感染，支持治疗。结果 49例患者全部随访6个月～2年均骨性愈合，无畸形。骨折愈合时间4～8个月，平均6个月，外固定架固定时间3～9个月，平均6个月。术后4例患者少量皮肤坏死，经换药痊愈。3例切口延期愈合。无钉道延重感染及螺钉松动。无缺血性肌挛缩。按照平定标准：治愈47例，好转2例，未愈0例。结论 抗氧化剂结合外固定架可以明显促进创伤软组织的修复及骨折愈合，符合中医“筋骨并重”的原则，是治疗胫腓骨骨折合并软组织损伤的有效方法。
Objective：To explore an efficient method for treating fracture of tibia and fibula with severe soft tissue injury. Methods：From May 2003 to October 2005 ,clinical data of 49 cases with fracture of tibia and fibula were analyzed retrospectively. After foced with lateral extermal fixation in emergency, the patients were treated with the next antioxidants：①20% Mannitol infection 250ml intravenous drop in 30minutes, per 6 -8h one time and sodium aescinate20mg was dissolved in 5 % dextrose,injected by intravenous dop（60 dorps per minute）, one time per day. The above-mentioned drugs were used 5 -7days. ②Mihiorrhiza injection 20ml was dissolved in 5 % dextrose or normal saline250ml, dropping through vein for 2 weeks, one time per day. Keeping the negative fluid balance and electrolyte balance in early stage, preventing infection and holding out treatment. Results：Fracture healed completesy in 49 cases after follow-up of 6 months to 2 years. No bone maiunion. The healing time of fracture was 4 - 8 months, with an average of 6 months. Fixed time of external fixation was 3 - 9 months, with an average of 6 months, A little of skin necrosis occurred on 4 cases after operation and healed by dressing change. The wound retarded to heal in 3 cases. No complication such as pinhole infection and pin loosening as well as ischemical muscle contracture. According to standard of effect ： Excellent got 47 cases, good 2 cases. Conclusion ： The antioxidants combined with external fixation can promotion the healing of traumatic soft tissues and the healing of fracture ,the therapeautic way is fitted for the principle of ＂ Jin as important as Bone＂ （筋骨并重）. It is an efficient way for treating fracture of tibia and fibula with soft tissue injury.
关键词
胫腓骨骨折
抗氧化剂
骨折固定
Fracture of tibia and fibula
Antioxidants
Fracture fixition
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