摘要
目的分析胫骨远端骨折内固定术后切口并发症及其相关的风险因素。方法纳入2008年1月—2011年12月行切开复位内固定治疗的125例胫骨远端骨折患者，其中男72例，女53例；平均年龄41.46岁。对患者的人口统计学数据（年龄、性别、吸烟史）、骨折类型、手术时间、受伤至手术时间及伴发疾病（糖尿病、周围血管疾病）等变量进行评估分析。对于需要进行换药处理、口服或静脉滴注抗生素或进一步手术治疗的患者，定义为切口并发症。结果125例均获得随访。其中1例（0.8％）出现切口并发症需实施手术清创处理，10例（8.0％）需进行切口换药、口服或静脉滴注抗生素治疗。Logistic回归显示，开放性骨折与切口并发症之间有相关性（OR=23.077，95％CI2.672～199.342，P〈0.01）；年龄与切口并发症之间有相关性（OR=1.078，95％CI1.011～1.150，P〈0.05）。性别、体重指数、吸烟史、受伤至手术时间、骨折类型、是否为多发伤及手术时间长短与切口并发症之间差异无统计学意义。结论胫骨远端骨折术后，高龄患者及开放性骨折发生切口并发症的风险大，对上述患者应做好围术期软组织管理，预防切口并发症发生。
Objective To identify risk factors for wound complications related to internal fixation of distal tibial fracture. Methods A total of 125 patients undergone open reduction and internal fixation of the distal tibial fracture between January 2008 and December 2011 were enrolled. There were 72 men and 53 women with mean age of 41.46 years. Factors contributing to operative wound complications assessed were demographic characteristics （age, gender, and smoking history）, types of fracture, operative time, time from injury to operation, and concomitant diseases （diabetes and peripheral vascular disease）. Patients with wound complications were defined as those requiring dressing care and oral or intravenous antibiotics or those requiring further surgical treatment. Results At follow-up, wound com- plications were recorded including 1 patient （0.8%） had surgical debridement and 10 patients （8.0%） had dressing care and oral or intravenous antibiotic therapy. Logistic regression analysis identified risk factors for wound comphcations were open fracture （ OR =23. 077,95% CI 2.672-199.342, P 〈0.01 ） and age （ OR = 1.078, 95% CI 1.011-1.150, P 〈 0.05 ）. Otherwise, following factors exhibited no sig- nificant correlation with wound complications： age, body mass index, smoking history, types of fracture, multiple injury or not, and operative time. Conclusion Patients with older age or open fracture present an increased risk of wound complications after operation and need special concern.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2014年第10期1018-1022,共5页
Chinese Journal of Trauma
基金
山东省自然科学基金资助项目（ZR2010HQ036）
关键词
胫骨骨折
骨折固定术
内
并发症
Tibial fractures
Fracture fixation
internal
Complications
