摘要
目的比较均压气囊止血带(equilibrium pressure pneumatic tourniquet,EPPT)和普通气囊止血带在双胫腓骨骨折内固定术中的止血效果及止血带损伤情况。方法 2008年5月-2010年5月,对21例双胫腓骨闭合骨折患者按左、右侧随机分为两组,在施行钢板内固定术时分别使用EPPT(EPPT组)和普通止血带(普通组)止血,止血带时间设定为60min,止血压力均为50kPa。男12例,女9例;年龄17～58岁,平均32.5岁。致伤原因:交通事故伤9例,重物砸伤6例,高处坠落伤6例。根据X线分型标准:EPPT组单纯型15例,蝶型3例,粉碎型3例;普通型组单纯型13例,蝶型5例,粉碎型3例。患者受伤至手术时间为3～72h,平均37.5h。结果 EPPT组及普通组止血带持续时间分别为(95.30±4.19)min及(94.11±5.16)min,差异无统计学意义(P>0.05)。两组术后切口均Ⅰ期愈合。术后2周普通组3例发生腓总神经损伤,经营养神经治疗3个月后恢复;1例出现皮肤水疱,经换药治疗后3周痊愈;止血带损伤率为19%。EPPT组无止血带损伤相关并发症发生,止血带损伤率为0。两组止血带损伤率比较,差异有统计学意义(P<0.05)。两组止血效果评定,EPPT组获优19例,良2例,优良率100%;普通组获优10例,良3例,差8例,优良率61.9%;两组比较差异有统计学意义(P<0.05)。术后患者均获随访,随访时间3～24个月。两组骨折均获骨性愈合,无骨折不愈合及畸形愈合。结论 EPPT与普通气囊止血带相比,止血压力低,止血效果好,术后并发症少。
Objective To compare the hemostatic effects and tourniquet induced side reactions of 2 different tourniquets in internal fixation of bilateral tibia and fibula fracture.Methods Between May 2008 and May 2010,21 patients with bilateral tibia and fibula fracture were treated and randomly divided into 2 groups according to left and right limbs.When steel plate fixation was performed,equilibrium pressure pneumatic tourniquet（EPPT group） and common tourniquet（common group） were used to staunch the flow of blood respectively.The time of using tourniquet was 60 minutes,and the hemostatic pressure was 50 kPa.There were 12 males and 9 females with an age range of 17 to 58 years（mean,32.5 years）.Injury was caused by traffic accident in 9 patients,by heavy pound in 6 patients,and falling from height in 6 patients.According to X-ray calssification,there were 15 cases of simple type,3 cases of butterfly type,and 3 cases of comminuted type in EPPT group;there were 13 cases of simple type,5 cases of butterfly type,and 3 cases of comminuted type in common group.The time from injury to operation was 3 to 72 hours（mean,37.5 hours）.Results The time of using tourniquet was（95.30 ± 4.19） minutes in EPPT group and（94.11 ± 5.16） minutes in common group,showing no significant difference（P 0.05）.All the incision of 2 groups healed by first intension.After 2 weeks of operation in common group,peroneal nerve injury occurred in 3 cases,and was cured by supporting nerve for 3 months;blister occurred in 1 case and was cured after dressing change for 3 weeks;and the injury rate was 19%.No complication occurred in EPPT group with an injury rate of 0.There was significant difference in the injury rate between 2 groups（P 0.05）.The hemostatic effects were excellent in 19 cases and good in 2 cases of EPPT group,were excellent in 10 cases,good in 3 cases,and poor in 8 cases of common group;the excellent and good rate were 100% and 61.9% respectively,showing significant difference（P 0.05）.All patients were followe
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第11期1338-1340,共3页
Chinese Journal of Reparative and Reconstructive Surgery
基金
青岛市科技局资助项目(KZD-04)~~
关键词
均压气囊止血带
止血效果
胫腓骨骨折
内固定术
Equilibrium pressure pneumatic tourniquet Hemostatic effect Tibia and fibula fracture Internal fixation
