84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]陸義安,薛鋒.跟骨骨折切開(kāi)復(fù)位內(nèi)固定術(shù)后切口愈合不良的危險(xiǎn)因素分析[J].中醫(yī)正骨,2018,30(04):43-45.
　LU Yian,XUE Feng.Analysis of risk factors for poor healing of incision after open reduction and internal fixation for treatment of calcaneus fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(04):43-45.
點(diǎn)擊復(fù)制

跟骨骨折切開(kāi)復(fù)位內(nèi)固定術(shù)后切口愈合不良的危險(xiǎn)因素分析()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年04期
頁(yè)碼:
43-45
欄目:
臨床研究
出版日期:
2018-04-20

文章信息/Info

Title:
Analysis of risk factors for poor healing of incision after open reduction and internal fixation for treatment of calcaneus fractures
作者:
陸義安; 薛鋒
上海市奉賢區(qū)中心醫(yī)院,上海 201499
Author(s):
LU Yian; XUE Feng
Fengxian District Central Hospital,Shanghai 201499,China
關(guān)鍵詞:
骨折固定術(shù); 內(nèi);  跟骨骨折;  傷口愈合;  危險(xiǎn)因素;  Logistic模型
Keywords:
Keywords fracture fixation; internal;  fracture of calcaneus;  wound healing;  risk factors;  Logistic models
摘要:
目的:分析跟骨骨折切開(kāi)復(fù)位內(nèi)固定術(shù)后切口愈合不良的危險(xiǎn)因素。方法:選取91例(91足)采用切開(kāi)復(fù)位內(nèi)固定術(shù)治療的閉合性跟骨骨折患者作為研究對(duì)象。男66例,女25例; 年齡22～80歲,中位數(shù)47歲; 高處墜落傷79例,車(chē)禍傷12例; 按照Sanders分型標(biāo)準(zhǔn),Ⅱ型40例、Ⅲ型39例、Ⅳ型12例; 傷后至手術(shù)時(shí)間3 h至15 d,中位數(shù)9 d。收集患者的病例資料,提取年齡、性別、骨折類(lèi)型、血清白蛋白水平、傷后至手術(shù)時(shí)間、是否進(jìn)行人工骨植骨、手術(shù)時(shí)間、切口縫合方式、切口愈合情況等信息。先采用單因素分析對(duì)自變量進(jìn)行篩選,再通過(guò)Logistic回歸分析確定跟骨骨折切開(kāi)復(fù)位內(nèi)固定術(shù)后切口愈合不良的危險(xiǎn)因素。結(jié)果:術(shù)后13例切口愈合不良(愈合不良組),其中8例患者出現(xiàn)切口皮緣壞死或裂開(kāi)、5例發(fā)生切口淺表感染,其余78例患者切口愈合良好(愈合良好組)。愈合不良組和愈合良好組骨折類(lèi)型、低白蛋白血癥(血清白蛋白<35 g·L-1)、傷后至手術(shù)時(shí)間、手術(shù)時(shí)間、切口縫合方式比較,組間差異均有統(tǒng)計(jì)學(xué)意義(χ2=10.202,P=0.006; χ2=6.398,P=0.011; χ2=3.863,P=0.049; χ2=4.658,P=0.031; χ2=8.729,P=0.003)。以切口愈合情況為因變量,將單因素分析結(jié)果中有意義的5個(gè)因素納入多因素Logistic回歸分析,結(jié)果顯示低白蛋白血癥(OR=1.757,P=0.000)、傷后至手術(shù)時(shí)間<7 d(OR=3.324,P=0.015)、手術(shù)時(shí)間>90 min(OR=4.379,P=0.003)及切口褥式縫合(OR=1.254,P=0.004)是跟骨骨折切開(kāi)復(fù)位內(nèi)固定術(shù)后切口愈合不良的危險(xiǎn)因素。結(jié)論:低白蛋白血癥、傷后至手術(shù)時(shí)間<7 d、手術(shù)時(shí)間>90 min及切口褥式縫合是跟骨骨折切開(kāi)復(fù)位內(nèi)固定術(shù)后切口愈合不良的危險(xiǎn)因素。
Abstract:
ABSTRACT Objective:To analyze the risk factors for poor healing of incision after open reduction and internal fixation for treatment of calcaneus fractures.Methods:Ninety-one patients(91 feet)with closed calcaneus fractures who had been treated with open reduction and internal fixation were selected as the subjects.The patients consisted of 66 males and 25 females,and ranged in age from 22 to 80 years(Median=47 yrs)and ranged in disease course from 3 hours to 15 days(Median=9 days).The fractures were caused by high falling injuries(79)and traffic accident injuries(12),and the fractures belonged to typesⅡ(40),Ⅲ(39)andⅣ(12)according to Sanders classification standard.The medical records of these patients were collected and the information about age,gender,fracture type,serum level of albumin,time from injury to surgery,artificial bone grafting,operative time,incision suturing method and incision healing were extracted for analysis.The independent variables were screened by using single-factor analysis and the risk factors for poor healing of incision after open reduction and internal fixation for treatment of calcaneus fractures were confirmed by using Logistic regression analysis.Results:The postoperative poor-healed incisions were found in 13 patients(poor-healed group),including skin necrosis or rupture at the incision margin(8)and superficial incision infection(5),and incisions healed well in the other patients(well-healed group).There was statistical difference in fracture type,hypoalbuminemia(serum albumin<35 g/L),time from injury to surgery,operative time and incision suturing method between poor-healed group and well-healed group(χ2=10.202,P=0.006; χ2=6.398,P=0.011; χ2=3.863,P=0.049; χ2=4.658,P=0.031; χ2=8.729,P=0.003).The incision healing was chosen as the dependent variable and the five significative factors chosen from the results of single-factor analysis were included in multiple-factor Logistic regression analysis.Finally the results demonstrated that hypoalbuminemia(OR=1.757,P=0.000),time from injury to surgery of<7 days(OR=3.324,P=0.015),operative time of>90 minutes-------------------(OR=4.379,P=0.003)and incision mattress-suture(OR=1.254,P=0.004)were the risk factors for postoperative poor healing of incision following open reduction and internal fixation for treatment of calcaneus fractures.Conclusion:Hypoalbuminemia,time from injury to surgery of<7 days,operative time of>90 minutes and incision mattress-suture are the risk factors for postoperative poor healing of incision following open reduction and internal fixation for treatment of calcaneus fractures.

參考文獻(xiàn)/References:

[1] 彭雄,邱波.跟骨外側(cè)U形切口結(jié)合解剖鋼板內(nèi)固定治療SandersⅢ、Ⅳ型跟骨骨折療效探討[J].生物骨科材料與臨床研究,2016,13(4):25-27.
[2] 吳群生.切開(kāi)復(fù)位可塑性鈦板內(nèi)固定聯(lián)合自體髂骨植骨治療跟骨關(guān)節(jié)內(nèi)骨折[J].中醫(yī)正骨,2017,29(2):57-59.
[3] 陳志軍,朱東波,王樹(shù)金,等.跗骨竇切口鋼板螺釘治療SandersⅡ、Ⅲ型跟骨骨折[J].臨床骨科雜志,2017,20(2):220.
[4] 沙良寬,田家祥,李敬祥,等.撬撥復(fù)位與切開(kāi)復(fù)位內(nèi)固定治療Sanders Ⅱ型跟骨骨折的比較[J].中國(guó)修復(fù)重建外科雜志,2015,29(5):558-562.
[5] 姚琦,仇永輝,祝孟海,等.跟骨骨折術(shù)后切口并發(fā)癥的分析及預(yù)防策略[J].中華創(chuàng)傷骨科雜志,2015,17(9):757-760.
[6] 董新利,蘇云,孫強(qiáng),等.改良間斷垂直褥式縫合方法在關(guān)閉跟骨骨折切口中的應(yīng)用[J].實(shí)用骨科雜志,2017,23(2):185-187.
[7] SINDGIKAR V,NARASANAGI B,TEJASVINI V,et al.Effect of serum albumin in wound healing and its relatedcomplications in surgical patients[J].AI Ameen J Med Sci,2017,10(2):132-135.
[8] SANDERS R.Displaced intra-articular fractures of the calcaneus[J].J Bone Joint Surg Am,2000,82(2):225-250.
[9] TALUKDAR M,GOPALARATHNAM S,PAUL R,et al.Clinical study on factors influencing wound dehiscence in emergency exploratory laparotomy[J].J Evolution Med Dent Sci,2016,5(34):1934-1938.
[10] AIGNER R,SALOMIA C,LECHLER P,et al.Relationship of prolonged operative time and comorbidities with complications after geriatric ankle fractures[J].Foot Ankle Int,2017,38(1):41-48.

相似文獻(xiàn)/References:

[1]溫超海,何忠,李永斌,等.閉合復(fù)位伽瑪釘改良成鎖定支架內(nèi)固定治療 老年股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(11):32.
[2]肖善富,張喜善,于鳳珍.髕下小切口鋼絲紐扣式內(nèi)固定治療脛骨髁間隆突骨折[J].中醫(yī)正骨,2015,27(11):34.
[3]朱峰,宋相建,吳蔚,等.手法復(fù)位經(jīng)皮克氏針內(nèi)固定治療 兒童閉合性肱骨遠(yuǎn)端全骨骺分離[J].中醫(yī)正骨,2015,27(11):51.
[4]袁偉,周曉莉.T形掌指骨微型鋼板內(nèi)固定治療鎖骨近端骨折[J].中醫(yī)正骨,2015,27(10):47.
[5]唐劍邦,吳宇峰,高大偉,等.切開(kāi)復(fù)位肱骨近端鎖定鋼板內(nèi)固定治療 陳舊性肩關(guān)節(jié)后脫位合并肱骨近端骨折[J].中醫(yī)正骨,2015,27(10):49.
[6]劉磊,萬(wàn)春友,全先輝,等.鎖定鋼板內(nèi)固定結(jié)合肱骨頭植骨重建治療 肱骨近端Neer三、四部分骨折[J].中醫(yī)正骨,2015,27(10):52.
[7]白晨平.微型自攻空心螺釘內(nèi)固定治療掌指骨關(guān)節(jié)內(nèi)骨折[J].中醫(yī)正骨,2015,27(09):34.
[8]錢(qián)平康,徐鋒,孫斌峰,等.肱骨近端內(nèi)鎖定系統(tǒng)固定結(jié)合植骨治療肱骨近端骨折[J].中醫(yī)正骨,2015,27(09):36.
[9]陳紅衛(wèi),王子陽(yáng),李軍,等.肘關(guān)節(jié)后外側(cè)入路聯(lián)合前內(nèi)側(cè)入路治療 肘關(guān)節(jié)恐怖三聯(lián)征[J].中醫(yī)正骨,2015,27(09):40.
[10]邢金明.切開(kāi)復(fù)位鎖定鋼板內(nèi)固定術(shù)和人工半肩關(guān)節(jié)置換術(shù) 治療老年肱骨近端復(fù)雜骨折的對(duì)比研究[J].中醫(yī)正骨,2015,27(08):11.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):11.
[11]王俊義,王巧迪.布巾鉗鉗夾復(fù)位經(jīng)皮克氏針內(nèi)固定術(shù)治療兒童和青少年閉合性鎖骨骨折[J].中醫(yī)正骨,2017,29(08):76.
[12]彭林,童培建.切開(kāi)復(fù)位內(nèi)固定結(jié)合帶骨膜髂骨板移植治療合并脛骨遠(yuǎn)端關(guān)節(jié)面缺損的Pilon骨折[J].中醫(yī)正骨,2018,30(07):64.
[13]程省,湯立新,趙玉果,等.切開(kāi)復(fù)位空心釘內(nèi)固定與閉合復(fù)位經(jīng)皮克氏針內(nèi)固定治療GeddaⅠ型Bennett骨折的比較研究[J].中醫(yī)正骨,2021,33(09):20.
　CHENG Sheng,TANG Lixin,ZHAO Yuguo,et al.A comparative study of open reduction and hollow screws internal fixation versus closed reduction and percutaneous Kirschner wires internal fixation for treatment of Gedda typeⅠBennett fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(04):20.

備注/Memo

備注/Memo:
通訊作者:薛鋒 E-mail:[email protected]
更新日期/Last Update: 2018-08-24