摘要
目的:探讨Ⅱ号方外敷对跟骨骨折术前消肿结合跗骨窦入路治疗跟骨骨折的临床疗效.方法:自2016年11月至2018年6月收治跟骨骨折患者67例,按照术前消肿方法不同分为对照组32例(冰敷)和研究组35例(Ⅱ号方外敷).研究组男21例,女14例;年龄36~52(44.07±7.31)岁;受伤至就诊时间2~6(4.32±1.68)h;左足9例,右足26例;骨折按照Sanders分型,Ⅱ型20例,Ⅲ型15例;入院后采用Ⅱ号方外敷消肿.对照组男22例,女10例,年龄40~52(46.79±5.47)岁;受伤至就诊时间2~5 (3.89±1.03)h;左足14例,右足18例;Sanders分型Ⅱ型19例,Ⅲ型13例;入院后冰袋外敷消肿,至第1次出现皮肤皱褶.两组肿胀缓解后,采用跗骨窦入路行切开复位内固定术治疗.观察并记录入院与第1次出现皮肤皱褶的足、踝周径,计算其差值,比较两组患者入院及第2、4、7天VAS评分及术前准备时间、手术时间、住院周期、骨折愈合时间.结果:研究组足、踝周径差值分别为(1.72±0.29) cm、(1.69士0.18) cm,对照组足、踝周径差值分别为(1.08±0.21) cm、(0.91士0.37) cm,研究组肿胀缓解程度优于对照组(P<0.05);研究组在入院第2、4、7天的VAS评分分别为8.91±0.33、6.47±1.09、4.52±0.91,对照组分别为6.21±0.19、3.67±1.18、2.12±1.17,研究组评分均低于对照组(P<0.05);研究组术前准备时间、住院时间及骨折愈合时间优于对照组(P<0.05),而两组手术时间 比较差异无统计学意义(P>0.05).结论:在跟骨骨折手围手术期间,合理应用Ⅱ号方,配合跗骨窦入路治疗跟骨骨折,能够有效改善患者伤口肿胀程度,缩短术前准备及骨折愈合周期,减轻疼痛,提高患者满意度,临床治疗效果显著.
Objective:To explore clinical effect of external application of No.Ⅱprescription on preoperative detumescence for the treatment of calcaneal fracture through tarsal sinus approach.Methods:From November 2016 to June 2018,67 patients with calcaneal fracture were divided into control group(32 patients with ice compress)and research group(35 patients with external application of No.Ⅱprescription)according to different methods of preoperative detumescence.There were 21 males and 14 females in research group,aged from 36 to 52 years old with an average of(44.07±7.31)years old;the time from injury to clinic ranged from 2 to 6 h with an average of(4.32±1.68)h;9 patients on the left side and 26 patients on the right side;20 patients were typeⅡ,15 patients were typeⅢaccording to Sanders classification;treated with external application of No.Ⅱprescription.There were 32 patients in control group,including 22 males and 10 females aged from 40 to 52 years old with an average of(46.79±5.47)years old;the time from injury to clinic ranged from 2 to 5 h with an average of(3.89±1.03)h;14 patients on the left side and 18 patients on the right side;19 patients were typeⅡand 13 patients were typeⅢaccording to Sanders classification;treated by ice compress from admission to the first time of occurrence of skin fold.After disappearance of swelling,patients were treated with open reduction and internal fixation through tarsal sinus approach.Cross-section diameter of foot and ankle between admission and the first time of occurrence of skin fold were recorded and calculated the difference value.VAS score on the 2nd,4th and 7th day after admission,preoperative prepare time,operative time,period of hospitalization and fracture healing time between two groups were compared.Results:Difference value of cross-section diameter of foot and ankle in research group were(1.72±0.29)cm and(1.69±0.18)cm respectively,while in control group were(1.08±0.21)cm and(0.91±0.37)cm,the level of swelling in research group was better than that of in control group.VAS score on the 2nd,4th and 7th day after admission in research group were 8.91±0.33,6.47±1.09,4.52±0.91 respectively;while in control group were 6.21±0.19,3.67±1.18,2.12±1.17 respectively;VAS score in research group was lower than control group.Preoperative prepare time,period of hospitalization and fracture healing time in research group were shorter than control group,while there was no statistical difference in operative time between two groups.Conclusion:During the perioperative period,rational application of No.Ⅱfor the treatment of calcaneal fracture through tarsal sinus approach could effectively relieve wound swelling,shorten preoperative preparation and fracture healing time,alleviate pain,improve patient satisfaction,and achieve remarkable clinical results.
作者
巴春
于俊龙
BA Chun;YU Jun-long(Yancheng Integrated Traditiongal Chinese and Westen Medicine Hospital,Yancheng 224100,Jiangsu,China)
出处
《中国骨伤》
CAS
CSCD
2019年第11期987-990,共4页
China Journal of Orthopaedics and Traumatology
关键词
跟骨
骨折
消肿
中药外敷
Calcaneus
Fractures
Subsiding swelling
External applications
