摘要
目的探究腓肠肌外侧头肌瓣联合植皮对胫骨外侧平台骨折术后切口感染的预后及炎性因子的水平影响分析。方法选取2014年5月-2016年5月于医院骨科进行手术治疗的胫骨外侧平台骨折且术后出现切口感染患者60例,采用前瞻性随机对照研究,将患者随机分为对照组和观察组,每组各30例;对照组患者给予彻底清创,观察组患者在对照组基础上给予腓肠肌外侧头肌瓣联合植皮治疗,比较两组患者术后切口感染的预后及炎性因子水平。结果观察组患者切口感染治愈率为96.67%,明显高于对照组的80.00%,观察组患者美观率93.33%,明显高于对照组的63.33%,差异有统计学意义(P<0.05),两组患者的色泽弹性差异明显(P<0.05);治疗前,两组患者Enneking下肢功能评分差异无统计学意义,治疗后,观察组患者评分明显高于对照组,差异有统计学意义(P<0.05);观察组患者骨折愈合率为96.67%,对照组为76.67%,差异有统计学意义(P<0.05);观察组患者切口愈合时间明显短于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平明显低于对照组,差异有统计学意义(P<0.05)。结论腓肠肌外侧头肌瓣联合植皮治疗胫骨外侧平台骨折术后切口感染疗效确切,值得临床推广。
OBJECTIVE To explore the influence of lateral head of gastrocnemius muscle flap combined with skin graft on prognosis of postoperative incision infections and expression of inflammatory factors of patients with lateral tibial plateau fractures.METHODS A total of 60 lateral tibial plateau fractures patients with postoperative incision infection who received surgical procedures in department of orthopedics from May 2014 to May 2016 were enrolled in the study and randomly divided into the control group and the observation group by means of prospective randomized controlled study, with 30 cases in each group.The control group was treated with thorough debridement, and the observation group was given additional lateral head of gastrocnemius muscle flap combined with skin graft on basis of the control group.The prognosis of postoperative incision infection and levels of inflammatory factors were observed and compared between the two groups of patients.RESULTS The cure rate of incision infection of the observation group was 96.67%, significantly higher than 80.00% of the control group;the elegant appearance rate of the observation group was 93.33%, significantly higher than 63.33% of the control group （P〈0.05）;there was significant difference in the color and elasticity between the two groups of patients （P〈0.05）.There was no significant difference in the Enneking lower limb function score between the two groups of patients before the treatment;however, the score of the observation group was significantly higher than that of the control group after the treatment （P＆lt;0.05）.The healing rate of fractures of the observation group was 96.67%, the control group 76.67%, and there was significant difference （P＆lt;0.05）.The healing time of incision of the observation group was significantly shorter than that of the control group （P〈0.05）.The levels of interleukin-6 （IL-6）, interleukin-8 （IL-8） and tumor necrosis factor-α（TNF-α） of the observation group were significantly lower than those of the control group （P〈0.05）.CONCLUSION The lateral head of gastrocnemius muscle flap combined with skin graft can achieve exact effect on treatment of the lateral tibial plateau fractures patients with postoperative incision infections, and it is worthy to be promoted in the hospital.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第16期3733-3736,共4页
Chinese Journal of Nosocomiology
关键词
胫骨外侧平台骨折
腓肠肌外侧头肌瓣
植皮
切口感染
炎性因子
Lateral tibial plateau fracture
Lateral head of gastrocnemius muscle flap
Skin graft
Incision infection
Inflammatory factor
