Masquelet技术联合人工真皮治疗四肢严重骨、软组织损伤的临床疗效研究

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英文篇名：Clinical efficacy of Masquelet technique combined with artificial dermis for severe bone and soft tissue injury of extremities 作者：许英 ; 刘魁 ; 贺银习 英文作者：Xu Ying;Liu Kui;He Yinxi;Department of Trauma Orthopaedics,The Third Hospital of Shijiazhuang; 关键词：Masquelet技术 ; 人工真皮 ; 皮瓣移植 ; 骨损伤 ; 软组织损伤 英文关键词：Masquelet technique;;artificial dermis;;flap transplantation;;bone injury;;soft tissue injury 中文刊名：GXYD 英文刊名：Journal of Guangxi Medical University 机构：河北省石家庄市第三医院创伤骨科二病区; 出版日期：2019-06-30 出版单位：广西医科大学学报 年：2019 期：v.36 基金：河北省石家庄市卫计委课题资助项目(No.20181042) 语种：中文; 页：GXYD201906022 页数：4 CN：06 ISSN：45-1211/R 分类号：105-108

摘要

目的:研究Masquelet技术联合人工真皮用于四肢严重骨、软组织损伤的临床效果。方法:选取2015年2月至2017年2月河北省石家庄市第三医院收治的80例四肢严重骨、软组织损伤患者,按随机数字表法分为观察组与对照组,每组40例。两组患者经清创治疗后,对照组实施Masquelet技术联合皮瓣移植手术治疗,观察组实施Masquelet技术联合人工真皮移植手术治疗。比较两组临床疗效、换药次数、伤口闭合时间、住院时间及并发症发生率。结果:观察组治疗总有效率为84.50%,对照组为82.50%,两组比较差异无统计学意义(P<0.05)。观察组换药次数少于对照组,伤口闭合时间和住院时间均短于对照组,差异均有统计学意义(均P<0.05)。观察组术后并发症总发生率为12.50%,与对照组(15.00%)比较差异无统计学意义(P>0.05)。结论:Masquelet技术联合皮瓣移植或人工真皮治疗四肢严重骨、软组织损伤的疗效满意,但Masquelet技术联合人工真皮可缩短患者住院时间,促进患者恢复。
        Objective:To study the clinical effect of Masquelet technique combined with artificial dermis on severe bone and soft tissue injury of extremities.Methods:From February 2015 to February 2017,80 patients with severe bone and soft tissue injuries in the extremities admitted to our hospital were selected,and randomly divided into an observation group and a control group,with 40 cases in each group.After debridement,the patients in the control group received Masquelet technique combined with skin flap transplantation,and those in the observation group received Masquelet technique combined with artificial dermis.The curative effect,frequency of dressing change,wound closure time,hospital days and the incidence of complications were compared.Results:The total effective rate of the observation group was 84.50%,and that of the control group was 82.50%.There was no significant difference between the two groups(P<0.05).Frequency of dressing change was less in the observation group compared with the control group,and wound closure time and hospital days were shorter(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:Masquelet technique combined with skin flap transplantation or artificial dermis achieved satisfactory clinical effect in the treatment of severe bone and soft tissue injury of the limbs.But the combination of Masquelet technique and artificial dermis could shorten the hospital days and promote the recovery of patients.

引文

[1]凌庆荣.改良负压封闭引流术联合利福平及高渗糖治疗软组织缺损合并骨外露感染的效果观察[J].广西医科大学学报,2015,32(6):995-996.
    [2]刘义军,魏爱淳,魏伟.外固定架结合有限内固定治疗伴有严重软组织损伤的股骨远端骨折[J].中国骨与关节损伤杂志,2016,31(6):27-28.
    [3]马焕林,吴杰,杨冬文.负压吸引术在四肢骨折伴严重软组织损伤中的应用[J].局解手术学杂志,2014,23(4):411-412.
    [4]MASQUELET A C,FITOUSSI F,BEGUE T,et al.Reconstruction of the long bones by the induced membrane and spongy autograft[J].Annales De Chirurgie Plastique Et Esthetique,2000,45(3):346-353.
    [5]殷渠东,顾三军,孙振中,等.Masquelet技术体外制作骨水泥填塞物治疗骨缺损的临床应用[J].中华创伤杂志,2016,32(4):370-372.
    [6]张耿明,李浩瑜.负压封闭引流术治疗四肢骨折合并严重软组织损伤的临床疗效观察[J].河北医学,2013,19(5):713-715.
    [7]李艳超.损伤控制对不稳定骨盆骨折并四肢骨折患者凝血功能影响及疗效分析[J].中国骨伤,2017,30(3):198-201.
    [8]徐可林,王建兵,吴永伟,等.应用Masquelet技术治疗骨缺损[J].中华创伤骨科杂志,2017,19(1):35-40.
    [9]肖卫东,喻爱喜,潘振宇,等.皮瓣移植联合Masquelet技术治疗骨及软组织缺损[J].中华显微外科杂志,2018,41(1):9-12.
    [10]刘少华,高建良,刘龙刚,等.人工真皮修复指腹皮肤软组织缺损[J].中华显微外科杂志,2017,40(6):598-600.
    [11]童伟林,唐芙蓉,项舟.负压封闭引流术治疗四肢骨折合并严重软组织损伤的临床效果观察[J].中国医药导报,2013,10(29):62-64.
    [12]马海东,高岩,李绍光,等.负压封闭引流在足部闭合复杂骨折脱位伴严重软组织损伤中的应用[J].中华医学杂志,2017,97(35):2746.