不同止血方法对跟骨骨折手术切口愈合的影响

摘要

目的：观察和对比分析电凝止血、钳夹止血及压迫止血对跟骨骨折手术切口愈合的影响。方法收集2012年12月～2015年12月收治的60例66足跟骨骨折患者临床资料，其中男性48例，女性12例；年龄18～59岁，平均36.6岁。均经跟骨外侧L形切口行切开复位钛板内固定术，术中止血方法分别采用电凝止血、钳夹止血及压迫止血。记录三组患者年龄、骨折分型、伤后至手术时间、手术时间、切口干燥时间、切口愈合时间、切口并发症发生率及足部功能Maryland评分等，并进行统计学分析。结果在切口干燥时间、切口愈合时间及切口并发症等方面钳夹止血组显著优于电凝止血组和压迫止血组（P＜0.05），而电凝止血组和压迫止血组之间无显著性差异（P＞0.05），三组足部功能Maryland评分无显著性差异（P＞0.05）。结论跟骨骨折术中行钳夹止血可明显降低切口并发症的发生率。%Objective To observe and compare the effects of electrocoagulation hemostasis, forceps hemo-stasis and compression hemostasis on the operative incision healing in calcaneal fracture patients.Methods From Dec.2012 to Dec.2015,60 patients with calcaneal fracture were treated.Among them 48 were male and 12 were fe-male ranged from 18 to 59 years(average,36.6 years).All cases (66 calcaneal fractures) were treated by open re-duction and internal fixation through L-type calcaneal lateral incision.Intra-operative hemostasis methods included the electrocoagulation hemostasis, forceps hemostasis and compression hemostasis. Indexes such as age, fracture classification,time from injury to operation,operation time,drying time and healing time of the incision,incidence of incision-related complications and Maryland foot function score among the 3 groups were recorded and statistically analyzed.Results The forceps hemostasis group was significantly better than the electrocoagulation hemostasis group and the compression hemostasis group in the drying time and healing time of the incision and the incidence of incision-related complications( P<0.05) ,while there was no significant difference between the electrocoagulation he-mostasis group and the compression hemostasis group(P>0.05) in the above 3 indexes.No significant difference was observed in Maryland foot function score among the three groups(P>0.05).Conclusion Forceps hemostasis could significantly reduce the incidence of incision-related complications during the calcaneal fracture operation.