急诊使用外固定架联合VSD处理四肢开放性骨折效果评价

黄新华

【摘要】 目的 研究四肢開放性骨折患者在急诊救治中使用外固定架联合负压封闭引流术（VSD）处理的效果。方法 120例四肢开放性骨折患者， 按照随机数字表法分为实验组与对照组， 各60例。对照组患者使用常规清创处理， 实验组患者在对照组基础上使用外固定架联合VSD处理， 观察比较两组患者软组织成活情况、并发症发生情况、创面愈合时间及创面感染发生情况。结果 实验组患者软组织成活率为96.67%， 明显高于对照组的75.00%， 差异具有统计学意义（P<0.05）。实验组患者并发症发生率为6.67%， 明显低于对照组的20.00%， 差异具有统计学意义（P<0.05）。实验组患者创面感染发生率为16.67%， 明显低于对照组的56.67%， 差异具有统计学意义（P<0.05）。实验组患者创面愈合时间为（5.82±1.56）个月， 对照组患者创面愈合时间为（7.89±2.54）个月， 实验组患者创面愈合时间明显短于对照组， 差异具有统计学意义（P<0.05）。结论 四肢开放性骨折患者在急诊救治中使用外固定架联合VSD处理的效果显著， 可提高软组织成活率， 缩短创面愈合时间， 降低并发症发生率和创面感染发生率， 值得临床应用。

【关键词】 急诊;外固定架;负压封闭引流术;四肢开放性骨折;临床效果

DOI：10.14163/j.cnki.11-5547/r.2019.21.006

【Abstract】 Objective   To study the effect of external fixator combined with vacuum sealing drainage （VSD） in emergency treatment of open fracture of extremities. Methods   A total of 120 patients with open fracture of extremities were divided by random number table method into experimental group and control group， with 60 cases in each group. The control group was treated with routine debridement， and the experimental group was treated with external fixator combined with VSD on the basis of the control group. Observation and comparison were made on survival rate of soft tissue， occurrence of complications， healing time of wound and occurrence of wound infection between the two groups. Results   The experimental group had obviously higher survival rate of soft tissue as 96.67% than 75.00% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had obviously lower incidence of complications as 6.67% than 20.00% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had obviously lower incidence of wound infection as 16.67% than 56.67% in the control group， and the difference was statistically significant （P<0.05）. The experimental group had wound healing time as （5.82±1.56） months， which was （7.89±2.54） months in the control group. The experimental group had obviously shorter wound healing time than the control group， and the difference was statistically significant （P<0.05）. Conclusion   External fixator combined with VSD is effective in emergency treatment of open fracture of extremities. It can improve the survival rate of soft tissue， shorten the time of would healing， reduce the incidence of complications and wound infection. It is worthy of clinical application.

【Key words】 Emergency; External fixator; Vacuum sealing drainage; Open fracture of extremities; Clinical effect