發(fā)布時間：2018-01-15 01:02

  本文關(guān)鍵詞：跟骨骨折切開復(fù)位內(nèi)固定術(shù)后切口愈合不良的相關(guān)因素分析　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 跟骨骨折 切開復(fù)位內(nèi)固定術(shù) 傷口愈合不良 單因素篩選 Logistic回歸分析

【摘要】：目的:本研究通過收集臨床病例,篩選出合適病例入組,收集研究數(shù)據(jù),探討導(dǎo)致跟骨骨折切開復(fù)位內(nèi)固定術(shù)后發(fā)生切口愈合不良的相關(guān)因素,通過統(tǒng)計分析其相關(guān)性等,為預(yù)防跟骨骨折切開復(fù)位內(nèi)固定術(shù)后出現(xiàn)傷口愈合不良提供理論依據(jù)及客觀的數(shù)據(jù)參考。方法:采用回顧性分析方法,在統(tǒng)一術(shù)前、術(shù)式、術(shù)后處理等的前提下,將研究對象通過骨折類型、傷后至手術(shù)時間的間隔、性別、年齡、手術(shù)時長等進行分類,通過術(shù)后觀察,門診復(fù)診及電話回訪等方式隨訪。對術(shù)后并發(fā)癥(切口皮膚壞死和切口感染)發(fā)生率進行統(tǒng)計學(xué)分析。結(jié)果:嚴(yán)格按照本研究納入標(biāo)準(zhǔn),本次研究共搜集廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院骨傷中心跟骨骨折行切開復(fù)位內(nèi)固定術(shù)的患者101例,其中按照診斷標(biāo)準(zhǔn)出現(xiàn)術(shù)后傷口愈合不良納入A組的有26例,術(shù)后傷口愈合良好的患者有75例。經(jīng)統(tǒng)計學(xué)分析后,單因素分析顯示,跟骨骨折切開復(fù)位內(nèi)固定術(shù)后兩周內(nèi)出現(xiàn)傷口愈合不良與患者的性別、年齡、骨折類型無相關(guān)性(P0.05),而與受傷后到手術(shù)的時間間隔、手術(shù)時長、術(shù)中是否植骨、術(shù)后是否服用活血化瘀中藥等顯著相關(guān)(P0.05)。對有相關(guān)性的研究因素進行Logistic回歸分析,結(jié)果顯示:除術(shù)中是否植骨這一因素外,其他因素均有相關(guān)性,按照獨立因素的作用強度排序為:手術(shù)時長、受傷后到手術(shù)的時間間隔、術(shù)后是否服用活血化瘀中藥。結(jié)論:通過本次研究得出,跟骨骨折手術(shù)時長、受傷后到手術(shù)的時間間隔、術(shù)后是否服用活血化瘀中藥等因素是影響跟骨骨折切開復(fù)位內(nèi)固定術(shù)后出現(xiàn)傷口愈合不良的獨立因素。故在處理跟骨骨折時,嚴(yán)格把握手術(shù)時機,評估后再決定手術(shù)的時機,熟練的手術(shù)技巧,縮短手術(shù)時長,術(shù)后予以患者活血化瘀的中藥,可以一定程度上減少跟骨骨折切開復(fù)位內(nèi)固定術(shù)后出現(xiàn)傷口愈合不良的發(fā)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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

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