【摘要】 目的探讨分析SandersⅡ～Ⅲ型跟骨骨折患者预后情况,为临床干预提供指导依据。方法方便选取2015年1月—2018年8月间该医院收治的80例SandersⅡ～Ⅲ型跟骨骨折患者,皆采用改良"L"型切口切开复位内固定手术进行治疗,术后进行跟踪随访,以创口并发症的发生情况作为预后的判断依据,分析影响预后的相关因素。结果该组研究的80例患者中,术后发生创口并发症者26例,发生率为32.50%。结合单因素与多因素分析,吸烟(Wald=36.347,P=0.000)、手术时机≤7 d(Wald=23.841,P=0.000)、手术时间>1.5 h(Wald=14.076,P=0.002)、皮瓣静态牵开方式(Wald=6.083,P=0.014)、术后未实施引流(Wald=13.468,P=0.009)是影响预后的独立危险因素。结论在跟骨骨折患者的临床治疗过程中,应嘱患者禁止吸烟,尽量在患者骨折7d后实施手术,改良术式缩短手术时间,选择动态皮瓣牵开方式,术后留置负压引流装置,从而降低创口并发症发生率,改善预后。更多还原

【Abstract】 Objective To investigate the prognosis of patients with Sanders Ⅱ-Ⅲ calcaneal fracture and to provide guidance for clinical intervention. Methods From January 2015 to August 2018, 80 patients with Sanders Ⅱ-Ⅲ calcaneal fracture in our hospital were convenient selected and treated with modified "L" incision open reduction and internal fixation,and were followed up after operation. Based on the occurrence of wound complications as the basis of prognosis, the related factors affecting prognosis were analyzed. Results Among the 80 cases, 26 cases(32.50%) had postoperative complications.Smoking(Wald=36.347,P=0.000), operation time ≤ 7 days(Wald=23.841,P=0.000), operation time > 1.5 hours(Wald=14.076,P=0.002), static retraction of flap(Wald=6.083,P=0.014) and no drainage after operation(Wald=13.468,P=0.009)were the main risk factors for prognosis. Conclusion In the course of clinical treatment of calcaneal fracture patients, smoking should be prohibited, operation should be carried out as far as possible after 7 days of fracture, operation time should be shortened, dynamic flap retraction mode should be selected, and negative pressure drainage device should be placed after operation, to reduce the incidence of wound complications and improve the prognosis.更多还原