跟骨骨折切开复位内固定术后切口愈合不良的相关因素分析

发布时间：2018-01-15 01:02

本文关键词：跟骨骨折切开复位内固定术后切口愈合不良的相关因素分析　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过收集临床病例,筛选出合适病例入组,收集研究数据,探讨导致跟骨骨折切开复位内固定术后发生切口愈合不良的相关因素,通过统计分析其相关性等,为预防跟骨骨折切开复位内固定术后出现伤口愈合不良提供理论依据及客观的数据参考。方法:采用回顾性分析方法,在统一术前、术式、术后处理等的前提下,将研究对象通过骨折类型、伤后至手术时间的间隔、性别、年龄、手术时长等进行分类,通过术后观察,门诊复诊及电话回访等方式随访。对术后并发症(切口皮肤坏死和切口感染)发生率进行统计学分析。结果:严格按照本研究纳入标准,本次研究共搜集广州中医药大学第一附属医院骨伤中心跟骨骨折行切开复位内固定术的患者101例,其中按照诊断标准出现术后伤口愈合不良纳入A组的有26例,术后伤口愈合良好的患者有75例。经统计学分析后,单因素分析显示,跟骨骨折切开复位内固定术后两周内出现伤口愈合不良与患者的性别、年龄、骨折类型无相关性(P0.05),而与受伤后到手术的时间间隔、手术时长、术中是否植骨、术后是否服用活血化瘀中药等显著相关(P0.05)。对有相关性的研究因素进行Logistic回归分析,结果显示:除术中是否植骨这一因素外,其他因素均有相关性,按照独立因素的作用强度排序为:手术时长、受伤后到手术的时间间隔、术后是否服用活血化瘀中药。结论:通过本次研究得出,跟骨骨折手术时长、受伤后到手术的时间间隔、术后是否服用活血化瘀中药等因素是影响跟骨骨折切开复位内固定术后出现伤口愈合不良的独立因素。故在处理跟骨骨折时,严格把握手术时机,评估后再决定手术的时机,熟练的手术技巧,缩短手术时长,术后予以患者活血化瘀的中药,可以一定程度上减少跟骨骨折切开复位内固定术后出现伤口愈合不良的发生率。
[Abstract]:Objective: this study collected clinical cases, selected suitable cases into the group, collected research data, to explore the causes of open reduction and internal fixation of calcaneal fracture caused by poor wound healing factors. To provide theoretical basis and objective data reference for prevention of poor wound healing after open reduction and internal fixation of calcaneal fracture through statistical analysis methods: retrospective analysis method was adopted before unified operation. Under the premise of operation and postoperative management, the study objects were classified by fracture type, the interval between injury and operation, sex, age, length of operation and so on. The incidence of postoperative complications (incision skin necrosis and incision infection) was analyzed statistically. Results: according to the criteria of this study. This study collected 101 patients with calcaneal fracture in the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine who underwent open reduction and internal fixation. According to the diagnostic criteria, there were 26 cases of poor wound healing in group A and 75 cases of good wound healing after operation. After statistical analysis, univariate analysis showed. There was no correlation between poor wound healing and gender, age and fracture type in two weeks after open reduction and internal fixation of calcaneal fracture (P 0.05). Whether the bone graft was performed during the operation, whether to take the Chinese medicine for promoting blood circulation and removing blood stasis after operation was significantly related to P0.05. Logistic regression analysis was carried out on the related factors. The results showed that there was correlation between the other factors except whether or not bone graft was performed during the operation. The order of action intensity of the independent factors was as follows: the duration of operation, the time interval from injury to operation. Conclusion: through this study, the operation time of calcaneal fracture is long, the time interval from injury to operation. Whether or not to take Chinese herbal medicine for promoting blood circulation and removing blood stasis after operation is an independent factor that affects the wound healing after open reduction and internal fixation of calcaneal fracture. Therefore, when dealing with calcaneal fracture, we should strictly grasp the opportunity of operation. After evaluation, the timing of surgery, skilled surgical skills, shorten the duration of surgery, postoperative treatment of traditional Chinese medicine to promote blood circulation and blood stasis. To some extent, it can reduce the incidence of poor wound healing after open reduction and internal fixation of calcaneal fracture.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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