改进型医用聚氨酯绷带石膏托治疗下肢骨折临床应用创新.docVIP

改进型医用聚氨酯绷带石膏托治疗下肢骨折临床应用创新 　　摘要：目的 探讨U型托结合足底单托的改进型高分子聚氨酯绷带下肢骨折的临床疗效。方法 将321例各类下肢骨折患者随机分成三组，即U型托结合足底单托的改进型高分子聚氨酯绷带固定，单纯足底单托高分子聚氨酯绷带固定，以及单纯U型托高分子聚氨酯绷带固定。随访比较各组石膏内皮肤卡压和石膏固定骨折端支撑不佳的发生率。结果 单纯足底单托高分子聚氨酯绷带固定组石膏内卡压的发生率明显高于其余各组；单纯U型托高分子聚氨酯绷带固定组石膏固定骨折端支撑不佳的发生率明显高于其余各组；U型托结合足底单托的改进型高分子聚氨酯绷带固定组支撑固定治疗效果理想，石膏卡压的发生率极低（P0.01）。该组107例患者均按时更换管型石膏或30～45 d后直接拆除石膏。结论 使用U型托结合足底单托的改进型高分子聚氨酯绷带进行骨科各类下肢石膏托固定可取得良好效果。 　　关键词：聚氨酯绷带；改进型；骨科外固定 　　Abstract：Objective To evaluate the clinical effects of treatment for lower extremity fractures with modified medical polyurethane plaster which includes U-shaped plaster and foot plaster. Methods 321 patients with lower limb fractures were assigned into 3 groups： A， U-shaped plaster and foot plaster fixation group； B， conventional plaster fixation group； C， U-shaped plaster fixation group. All the patients were followed up and compared the condition of skin entrapment and poor support of plaster fixation.Results Compared with group A and C，there was a higher incidence of skin entrapment in patients of conventional plaster immobilization group. Compared with group A and B， there was a higher incidence of poor support of plaster fixation in patients of U-shaped plaster fixation group. The patients of U-shaped plaster and foot plaster fixation group got good results in plaster support and skin protection. And the statistical analysis showed a significant difference （P0.01）.Conclusion The modified medical polyurethane plaster may provide an effective method for immobilization of fractures of the lower limb and reduce the incidence of complication. 　　Key words：Polyurethane bandage；Modified；Orthopeadic external fixation 　　近年来，医用聚氨酯绷带（即高分子石膏）临床应用日趋广泛[1]。本文作者于2012年10月起至今，在临床实践的基础上对医用聚氨酯绷带技术进行改良，采用U型托结合足底单托的改进型高分子聚氨酯绷带固定方法对下肢骨折进行外固定，希望在保持其固定强度大等优点的同时避免其局部卡压和弹性过大的缺点。本研究将该技术与传统的单纯足底单托高分子聚氨酯绷带固定和单纯U型托高分子聚氨酯绷带固定临床疗效进行比较，以探讨其全面应用于各类下肢骨折石膏托外固定的可行性。 　　1资料与方法 　　1.1一般资料 医用聚氨酯绷带使用上海曼吉磁生物有限公司的4寸（10 cm）医用聚氨酯绷带；石膏绵纸和纱布绷带均使用上海医用敷料有限公司产品。 　　1.2方法 下肢石膏托固定患者每种固定方法随机挑选107例患者，