分步延期手术治疗高能量Pilon骨折的临床研究.pdfVIP

论著·临床论坛 CHINESEC0MMUNITY D0CT0RS 分步延期手术治疗高能量Pilon骨折的临床研究 谭安 向兴胜 伍松涛 404500重庆市云阳县人民医院 doi:10.3969/j.issn.1007-614x.2014.32.27 摘 要 目的：探讨分步延期手术治疗高能量Pilon骨折的优势与临床效果。方法：2012年3月-2014年5月收治Pilon 骨折患者60例，分为观察组和对照组。观察组采用分步延期手术进行治疗，对照组均于患者伤后8h内予以切开复位 内固定术。比较两组患者的术中出血量、骨折愈合时间、并发症发生率及手术优良率。结果：观察组出血量及并发症 发生率均明显低于对照组，手术优良率70.00%，高于对照组的50.00%，比较均有统计学意义(P＜0.05)。结论：分步延 期手术治疗Pilon骨折在手术方式以及手术时机的选择方面都更恰当，可以有效减少术中出血量、降低并发症发生率 并强化手术效果，提高优良率，值得大力推广。 关键词 分步延期手术；Pilon骨折；关节面；软组织损伤 ClinicalstudyonfractionaldelayoperationinthetreatmentofhighenergyPilonfracture TanAn,XiangXingsheng,WuSongtao ThePeoplesHospitalofYunyangCounty,ChongqingCity404500 Abstract Objective:ToinvestigatetheadvantageoffractionaldelayoperationinthetreatmentofhighenergyPilonfractureand itsclinicaleffect.Methods:60patientswithPilonfractureswereselectedfromMarch2012toMay2014.Theyweredividedintothe observationgroupandthecontrolgroup.Theobservationgroupweretreatedwithdistributionofdelayedoperation,andpatientsin thecontrolgroupweretreatedwithopenreductionandinternalfixationwithin 8 hafterinjury.Theamountofintraoperative bleeding,fracturehealingtime,complicationsandtheratioofexcellentoperationofpatientsintwogroupswerecompared.Results: Theamountofbleedingandcomplicationratesoftheobservationgroupweresignificantlylowerthanthatofthecontrolgroup.The excellentandgoodrateintheobservationgroupwas70%,higherthanthatofthecontrolgroupwas50%,andthedifferencewas statisticallysignificant(P＜0.05).Conclusion:Bothintheselectingofoperationmodeorthetimingofoperation,fractionaldelay operationismoreappropriateinthetreatmentofPilonfracture.Thistreatmentcaneffectivelyreducetheintraoperativebleeding volume,andalsoreducetheincidenceofcomplicationsandstrengthentheoperationeffect,inaddation,itcanimprovetheexcellent rate,soitisworthyofpopularation. Keyw