摘要
目的 探讨急诊清创一期复位内固定联合负压封闭引流(vacuum sealing drainage, VSD)治疗四肢开放性骨折的临床疗效。方法 选择2023年1月至2024年12月厦门市第五医院收治的58例四肢开放性骨折患者为研究对象。根据随机数字表法进行分组,分为观察组(急诊清创一期复位内固定联合VSD治疗,29例)和对照组(传统的急诊清创一期复位外固定治疗,二期再行内固定治疗,29例)。比较两组患者的临床疗效优良率、围手术期指标、并发症发生情况。结果 术后6个月,观察组患者临床疗效优良率显著高于对照组(96.55% vs.72.41%,P<0.05)。观察组患者手术时间、创面愈合时间、住院时间明显短于对照组(P<0.001)。观察组患者术后6个月的SF-36评分在生理功能、情感职能、社会功能、心理健康、躯体疼痛五个维度均显示优于对照组,差异具有统计学意义(P<0.05)。观察组患者的并发症总发生率显著低于对照组(6.90% vs. 27.59%,P<0.05)。两组患者术中出血量无显著差异(P>0.05)。结论 对于四肢开放性骨折患者,急诊清创一期复位内固定联合VSD治疗有利于促进患者肢体功能恢复和提高治疗效果,促进患者康复,提高患者生活质量,降低并发症的发生风险。
Objective To investigate the clinical efficacy of emergency debridement with primary reduction and internal fixation combined with vacuum sealing drainage(VSD)in the treatment of open limb fractures.Methods A total of 58 patients with open limb fractures admitted to Xiamen Fifth Hospital between January 2023 and December 2024 were enrolled in this study.They were randomly assigned via a random number table into two groups:the observation group(emergency debridement with primary reduction and internal fixation combined with VSD,n=29)and the control group(traditional emergency debridement with primary reduction and external fixation,followed by secondary internal fixation,n=29).The excellent-good rate of clinical efficacy,perioperative indicators,and incidence of complications were compared between the two groups.Results At 6 months postoperatively,the excellent-good rate of clinical efficacy in the observation group was significantly higher than that in the control group(96.55%vs.72.41%,P<0.05).The operation time,wound healing time,and hospital stay in the observation group were significantly shorter than those in the control group(P<0.001).At 6 months postoperatively,the SF-36 scores of the observation group were superior to those of the control group in five dimensions—physical function,emotional role,social function,mental health,and bodily pain—with statistically significant differences(P<0.05).The total complication rate in the observation group was significantly lower than that in the control group(6.90%vs.27.59%,P<0.05).No significant difference was observed in intraoperative blood loss between the two groups(P>0.05).Conclusion For patients with open limb fractures,emergency debridement with primary reduction and internal fixation combined with VSD facilitates functional recovery,improves therapeutic outcomes,accelerates rehabilitation,enhances quality of life,and reduces the risk of complications.
作者
苏丽凤
郭玲玲
SU Lifeng;GUO Lingling(Hand and Foot Surgery Department of Xiamen Fifth Hospital,Xiamen 361101,China;Digestive Endoscopy Room of Xiamen Fifth Hospital,Xiamen 361101,China)
出处
《中华灾害救援医学》
2025年第6期665-669,674,共6页
Chinese Journal of Disaster Medicine
基金
2021年厦门市医疗卫生指导性项目(3502Z20214ZD1255)。
关键词
急诊复位内固定
负压封闭引流
四肢开放性骨折
Emergency reduction and internal fixation
Vacuum sealing drainage
Open limb fractures
