组合换药法预防跟骨骨折术后皮缘坏死的临床效果(1)
[摘要]目的：探讨组合换药法预防跟骨骨折术后皮缘坏死的临床效果。方法：选取2016年10月-2017年10月在笔者医院治疗的跟骨骨折患者72例，采用随机数字表法，将患者随机分为观察组(n=37)和对照组(n=35)，两组均给予切开复位内固定，其中观察组给予组合换药方法，对照组给予传统换药方法，观察两组术后皮缘坏死情况，采用美国足踝外科协会(AOFAS)踝和后足功能评分系统评价足踝功能，同时对患者伤口满意度进行调查。结果：观察组术后皮缘坏死发生率为0.00%，明显低于对照组的17.14%，差异有统计学意义(P<0.05)；观察组术后6个月AOFAS评分为(84.39±9.14)分，明显高于对照组的(75.48±8.13)分，差异有统计学意义(P<0.05)；观察组患者伤口满意率为91.89%，明显高于对照组的74.29%，差异有统计学意义(P<0.05)。结论：组合换药法能有效预防跟骨骨折术后皮缘坏死，有助于足踝功能恢复，患者满意度高。
[关键词]组合换药法；跟骨骨折；皮缘坏死；临床效果
, 百拇医药
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)12-0047-03
Clinical Effect of Combined Dressing Change to Prevent Skin Necrosis after Calcaneal Fracture Operation
LI Xian-lan1，GU Xiao-mei2，FAN Yun2
(1.Department of Nursing；2.Department of Orthopaedics；Neijiang Traditional Chinese Medicine Hospital，Neijiang 641000，Sichuan，China)
Abstract： Objective To investigate the clinical effect of combined dressing change in preventing skin necrosis after calcaneal fracture operation. Methods 72 cases of calcaneal fracture in our hospital from October 2016 to October 2017 were selected， were randomly divided into the observation group (n=37) and the control group (n=35) by random digital table method， the two groups were treated by open reduction and internal fixation， and the observation group was given a combination of dressing change， while the control group was given traditional dressing change， the skin necrosis in the two groups was observed， the ankle and foot function scoring system of the American foot and ankle surgery association (AOFAS) was used to evaluate the function of the foot andankle， and the satisfaction of the patients was investigated. Results The incidence of necrosis of the skin margin in the observation group was 0.00%， which was significantly lower than in the control group(17.14%)， the difference was statistically significant(P<0.05). The AOFAS score of the observation group at 6 months after operation was(84.39±9.14)， which was significantly higher than that of the control group (75.48±8.13， P<0.05). The wound satisfaction rate of the patients in the observation group was 91.89%， which was significantly higher than that in the control group (74.29%， P<0.05). Conclusion Combined dressing change can effectively prevent skin necrosis after calcaneal fracture surgery， help ankle function recovery， and patients' satisfaction is high.
, 百拇医药
Key words： combined dressing change； calcaneal fracture； skin margin necrosis； clinical effect
临床上流行病学研究认为，跟骨骨折术后皮缘坏死的发生率可达734～955/1万人[1]。跟骨骨折术后皮缘坏死的发生能够导致患者伤口迁延不愈，增加了患者的院内感染风险[2]。常规换药治疗能够降低伤口感染的风险，促进伤口愈合。但长期的临床随访研究认为，单纯常规换药治疗术后皮缘坏死的临床总体有效率較低，治疗后的切口愈合等级较差，患者满意度较低[3]。而组合换药方法能够通过针对伤口愈合过程中不同的时期，采用针对性的辅助治疗药剂，从而减少了伤口渗液、促进了残留组织的清除，并为组织的愈合提供保障[4-5]。部分研究者报道了组合换药方式在促进腹部手术患者术后切口愈合方面的价值，认为其可以显著缩短组织愈合的时间，降低院内感染的风险[6]，但在跟骨骨折患者术后中的研究不足。为了指导临床上骨折术后皮缘坏死的诊疗，本研究选取2016年10月-2017年10月在笔者医院治疗的跟骨骨折患者72例，探讨了组合换药治疗的效果，现报道如下。, 百拇医药(李显兰 古晓梅 范芸)
[关键词]组合换药法；跟骨骨折；皮缘坏死；临床效果
, 百拇医药
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)12-0047-03
Clinical Effect of Combined Dressing Change to Prevent Skin Necrosis after Calcaneal Fracture Operation
LI Xian-lan1，GU Xiao-mei2，FAN Yun2
(1.Department of Nursing；2.Department of Orthopaedics；Neijiang Traditional Chinese Medicine Hospital，Neijiang 641000，Sichuan，China)
Abstract： Objective To investigate the clinical effect of combined dressing change in preventing skin necrosis after calcaneal fracture operation. Methods 72 cases of calcaneal fracture in our hospital from October 2016 to October 2017 were selected， were randomly divided into the observation group (n=37) and the control group (n=35) by random digital table method， the two groups were treated by open reduction and internal fixation， and the observation group was given a combination of dressing change， while the control group was given traditional dressing change， the skin necrosis in the two groups was observed， the ankle and foot function scoring system of the American foot and ankle surgery association (AOFAS) was used to evaluate the function of the foot andankle， and the satisfaction of the patients was investigated. Results The incidence of necrosis of the skin margin in the observation group was 0.00%， which was significantly lower than in the control group(17.14%)， the difference was statistically significant(P<0.05). The AOFAS score of the observation group at 6 months after operation was(84.39±9.14)， which was significantly higher than that of the control group (75.48±8.13， P<0.05). The wound satisfaction rate of the patients in the observation group was 91.89%， which was significantly higher than that in the control group (74.29%， P<0.05). Conclusion Combined dressing change can effectively prevent skin necrosis after calcaneal fracture surgery， help ankle function recovery， and patients' satisfaction is high.
, 百拇医药
Key words： combined dressing change； calcaneal fracture； skin margin necrosis； clinical effect
临床上流行病学研究认为，跟骨骨折术后皮缘坏死的发生率可达734～955/1万人[1]。跟骨骨折术后皮缘坏死的发生能够导致患者伤口迁延不愈，增加了患者的院内感染风险[2]。常规换药治疗能够降低伤口感染的风险，促进伤口愈合。但长期的临床随访研究认为，单纯常规换药治疗术后皮缘坏死的临床总体有效率較低，治疗后的切口愈合等级较差，患者满意度较低[3]。而组合换药方法能够通过针对伤口愈合过程中不同的时期，采用针对性的辅助治疗药剂，从而减少了伤口渗液、促进了残留组织的清除，并为组织的愈合提供保障[4-5]。部分研究者报道了组合换药方式在促进腹部手术患者术后切口愈合方面的价值，认为其可以显著缩短组织愈合的时间，降低院内感染的风险[6]，但在跟骨骨折患者术后中的研究不足。为了指导临床上骨折术后皮缘坏死的诊疗，本研究选取2016年10月-2017年10月在笔者医院治疗的跟骨骨折患者72例，探讨了组合换药治疗的效果，现报道如下。, 百拇医药(李显兰 古晓梅 范芸)
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