摘要
目的:观察和对比钳夹止血、电凝止血与压迫止血对胫骨平台内侧骨折手术切口愈合的影响。方法:选择2013年12月至2016年12月南通市通州区中医院收治的72例胫骨平台内侧骨折患者为研究对象,均经内侧手术入路治疗,植骨填充复位外侧平台满意后以克氏针固定;直视下复位胫骨平台后内侧骨折,以4.5 mm空心螺钉和支持钢板内固定。术中止血方法分别采用钳夹止血、电凝止血及压迫止血。记录3组患者年龄、骨折分型、手术时间、切口干燥时间、切口愈合时间,术后进行临床和影像学随访,行美国特种外科医院(the Hospital for Special Surgery,HSS)膝关节评分和骨关节炎Kellgren-Lawrence评分评估患者的膝关节功能恢复情况。结果:3组患者在切口干燥时间、愈合时间、手术时间上比较,差异无统计学意义(P?0.05)。3组患者在膝关节HSS、骨关节炎Kellgren-Lawrence评分上比较,差异无统计学意义(P?0.05)。结论:胫骨平台内侧骨折术中行钳夹止血、电凝止血与压迫止血,止血效果差别不明显。
Objective:To observe and compare the effects of forceps hemostasis,electrocoagulation hemostasis and compressionhemostasis on the operative incision healing in posteromedial tibiall plateau fracture. Methods:From Dec 2013 to Dec 2016,72 patients with posteromedial tibiall plateau fracture were selected. All patients were treated with posteromedial surgical approach. Theposterolateral impaction was addressed directly through the main fracture gap from anteromedial to posterolateral,and preliminarilyfixed with separate K-wire. Then the posteromedial fragment was reduced and applied with a buttress locking plate in theposteromedial position when the pes anserinus and midial collateral ligament were preserved. Intra-operative hemostasis methodsincluded the forceps hemostasis,electrocoagulation hemostasis and compression hemostasis. Age,fracture classification,operationtime,drying time and healing time of the incision,and incidence of incision-related complications among the 3 groups were recorded.Clinical and radiological follow-up was performed. Evaluation criteria included the Hospital for Special Surgery(HSS)score andKellgren-Lawrence score. Results:There were no significant difference among the 3 groups in operation time,drying time andhealing time of the incision. And there were also no significant difference among the 3 groups in HSS scores,Kellgren-Lawrencescores(P>0.05). Conclusion:The hemostatic effect of forceps hemostasis,electrocoagulation hemostasis and compressionhemostasis is not significantly different on the operative incision healing in posteromedial tibiall plateau fracture.
出处
《沈阳医学院学报》
2018年第1期35-37,共3页
Journal of Shenyang Medical College
关键词
胫骨平台骨折
手术
电凝止血
钳夹止血
压迫止血
posteromedial tibiall plateau fracture
operation
electrocoagulation hemostasis
forceps hemostasis
compression hemostasis
