摘要
目的探讨桃红四物汤结合负压封闭引流(VSD)技术对足部闭合复杂骨折脱位伴重度软组织损伤患者预后情况的影响。方法回顾性分析2016年1月~2018年8月我院骨伤科收治的足部闭合复杂骨折脱位伴严重软组织损伤的病例56例。按照治疗方式不同分为桃红四物汤结合VSD组(A组:28例)及参照组(B组:28例),所有患者均予切开复位内固定术或关节融合术。A组应用桃红四物汤结合负压封闭引流技术覆盖伤口及创面,术后持续负压引流。B组施以临床传统疗法,无菌清创包扎换药后待创面新鲜,行游离植皮或皮瓣移植修复皮瓣。观察两组创面清洁时间、换药次数、抗菌药物使用时间等手术情况;对比两组患者术前住院时间、总住院时间和切口愈合时间等治疗情况;对比两组患者的治疗效率及伤口的预后情况。结果两组患者手术时间无明显差异(P>0.05)。但A组创面清洁时间、换药次数、抗菌药物使用时间均少于B组患者(P<0.05)。两组患者术前住院时间差异无统计学意义(P>0.05)。B组总住院时间和切口愈合时间均明显比A组长(P<0.05)。A组患者治疗效果也明显比B组好(P<0.05)。A组术后植皮或皮瓣移植少于B组(P<0.05)。结论桃红四物汤结合负压封闭引流(VSD)技术对足部闭合复杂骨折脱位伴重度软组织损伤患者预后疗效显著,提高伤口愈合效率。
Objective To investigate the effect of Taohong Siwu decoction combined with vacuum sealing drainage(VSD)on the prognosis of patients with complex closed foot fracture and dislocation complicated with severe soft tissue injury.Methods A retrospective analysis was carried out on 56 patients with complex closed foot fracture and dislocation complicated with severe soft tissue injury who were admitted to the department of orthopedics in our hospital from January 2016 to August 2018.According to different treatment methods,they were divided into VSD group(group A,28 cases)and control group(group B,28 cases).All patients were given open reduction and internal fixation or arthrodesis.The group A was given Taohong Siwu decoction combined with vacuum sealing drainage to cover the wound and wound surface,and negative pressure drainage was continued after operation.The group B was given traditional clinical therapy.Until the wound surface was fresh after the sterile debridement dressing,the skin flap was repaired by free skin graft or flap transplantation.The operation conditions such as wound cleaning time,the number of dressing changes,and the time of use of antibacterial drugs were observed in the two groups;the treatment conditions including preoperative length of hospital stay,total length of hospital stay and incision healing time were compared between the two groups;the treatment efficiency was compared between the two groups of patients.The prognosis of the wounds was compared between the two groups.Results There was no significant difference in the operation time between the two groups(P>0.05).However,the wound cleaning time,the number of dressing changes,and the time of antibacterial use in the group A were less than those in the group B(P<0.05).The preoperative length of hospital stay was the same in both groups(P>0.05).The total hospital stay and wound healing time in the group B were significantly longer than those in the group A(P<0.05).The therapeutic effect of patients in the group A was also significantly b
作者
邵营钢
沈忠伟
潘涛
姚晓冬
闵重函
SHAO Yinggang;SHEN Zhongwei;PAN Tao;YAO Xiaodong;MIN Zhonghan(Department of Orthopedics,Jiaxing Hospital of TCM in Zhejiang Province,Jiaxing314001,China)
出处
《中国现代医生》
2019年第36期80-83,共4页
China Modern Doctor
基金
浙江省中医药科技计划项目（2015ZB116）
关键词
桃红四物汤
负压封闭引流
足部闭合性骨折
脱位
皮肤软组织损伤
Taohong Siwu decotion
Vacuum sealing drainage(VSD)
Closed foot fracture
Dislocation
Skin soft tissue injury
