人类免疫缺陷病毒阳性青年男性患者四肢闭合骨折内固定术后切口延迟愈合影响因素的研究

发布时间：2018-01-27 13:31

  本文关键词： 人类免疫缺陷病毒 骨折 切口愈合 内固定　出处：《中国矫形外科杂志》2017年02期 　论文类型：期刊论文

【摘要】：[目的]探讨人类免疫缺陷病毒(human immunodeficiency virus,HIV)阳性青年男性患者四肢闭合骨折行切开复位钢板螺钉内固定术后切口延迟愈合发生率,以及探究这类患者术后切口延迟愈合的危险因素。[方法]对2012年5月~2014年12月于本院因明确外伤所致四肢闭合性骨折并行切开复位钢板螺钉内固定术的52例HIV阳性青年男性患者进行回顾性分析。根据患者切口愈合情况分为切口延迟愈合组和正常愈合组,分别记录患者年龄,骨折部位,切口长度,切口缝合方式,手术时间,外周血CD4+T细胞计数,血红蛋白,血清白蛋白等,记录这类患者术后切口延迟愈合的发生率,比较两组间以上各因素的差异性,探究与切口延迟愈合相关的危险因素。[结果]52例患者均成功接受切开复位钢板螺钉内固定术,手术顺利,未见明显手术及麻醉并发症发生。术后切口延迟愈合的发生率为26.92%(14例),其中发生切口裂开12例(23.07%),发生切口脂肪液化2例(3.85%)。与正常愈合组相比,延迟愈合组下肢骨折和皮内缝合的比率较高(下肢骨折78.57%vs 44.74%,皮内缝合71.43%vs 39.47%),切口相对较长[(7.79±1.80)cm vs(6.87±1.67)cm],术前外周血CD4+T细胞计数200 cells/mm3的比率较高(21.43%vs 0%),外周血白细胞计数较低[(5.98±1.78)×109/L vs(7.30±1.21)×109/L],血清白蛋白水平较低[(34.07±3.60)g/L vs(38.53±4.32)g/L],血红蛋白水平较低[(100.43±9.62)g/L vs 107.08±9.34)g/L]。[结论]HIV阳性青年男性患者四肢闭合骨折行切开复位内固定术后切口延迟愈合的发生率为26.92%,且延迟愈合的发生与手术部位、切口长度、切口缝合方式、术前外周血CD4+T细胞计数、白细胞计数、血红蛋白以及血清白蛋白水平等因素相关。
[Abstract]:[Objective] to investigate the human immunodeficiency virus of human immunodeficiency virus. The incidence of delayed wound healing after open reduction plate and screw fixation and the risk factors of delayed wound healing were investigated in HIV-positive young male patients with closed fracture of extremities. [Methods] from May 2012 to December 2014, 52 young male patients with HIV positive were treated with open reduction, plate and screw internal fixation for closed fracture of extremities caused by definite trauma in our hospital. According to the wound healing condition, the patients were divided into two groups: delayed wound healing group and normal healing group. Age, fracture site, incision length, incision suture, operation time, peripheral blood CD4 T cell count, hemoglobin and serum albumin were recorded. The incidence of delayed wound healing was recorded, the differences of above factors between the two groups were compared, and the risk factors related to delayed wound healing were explored. [Results: 52 patients were successfully treated with open reduction, plate and screw internal fixation, and the operation was successful. There were no obvious complications of operation and anesthesia. The incidence of delayed healing of incision was 26.92 cases, of which 12 cases had incision rupture (23.07%). The rate of lower extremity fracture and intradermal suture in delayed healing group was higher than that in normal healing group (78.57 vs 44.74%). Intradermal suture 71.43 vs 39.47. The incision is relatively long. [7.79 卤1.80cm. vs(6.87 卤1.67cm. The ratio of peripheral blood CD4 T cell count 200 cells/mm3 before operation was higher than 21.43% vs 0%, and the peripheral white blood cell count was lower. [5. 98 卤1. 78) 脳 10 ~ 9 / L vs(7.30 卤1. 21 脳 10 ~ 9 / L] and lower serum albumin levels. [34.07 卤3.60 g / L vs(38.53 卤4.32 g / L, lower hemoglobin level. [100.43 卤9.62 g / L vs 107.08 卤9.34 g / L]. [Conclusion: the incidence of delayed wound healing after open reduction and internal fixation in young male patients with HIV positive was 26.92, and the delayed healing occurred with the site of operation and the length of incision. CD4 T cell count, leukocyte count, hemoglobin and serum albumin level were correlated with incision suture.
【正文快照】： 114 Vol.25,No.2 Jan.2017 中国矫形外科杂志 Orthopedic Journal of China 第 25 卷 第 2 期 2 0 1 7 年 1 月 · 临床论著 · 人类免疫缺陷病毒阳性青年男性患者四肢闭合骨折 内固定术后切口延迟愈合影响因素的研究 △ 赵汝岗，，赵昌松，李 鑫，

本文编号：1468586