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目的探讨锁定钢板内固定治疗胫骨平台骨折的护理体会。方法回顾分析2008年6月-2013年8月江苏大学附属武进医院骨科收治胫骨平台骨折患者82例,结合护理方式及患者术后HSS功能评分标准评估护理效果及安全性。结果 82例患者均获得临床随访,随访时间12~23个月,平均(19.5±5.8)个月。所有患者均取得骨性愈合,骨愈合时间11~19周,平均(14.5±3.4)周。随访过程中未发现断钉、钢板松动、腓总神经损伤及深静脉血栓等并发症发生。末次随访时,依据HSS评分标准:优40例,良34例,可5例,差3例,优良率达到90.24%。在术后并发症方面:深部感染4例,浅表感染3例。7例患者经临床彻底清创、负压封闭引流技术(VSD)及皮瓣或肌瓣转移后均取得临床痊愈。结论对于胫骨平台骨折而言,围手术期优质护理是手术疗效和手术并发症防治的有效保障,可以很好的提高患者的治疗优良率,值得临床推广。
Objective To investigate the nursing experience of locking plate internal fixation for tibial plateau fractures. Methods A retrospective analysis of 82 cases of tibial plateau fractures admitted to Wujin Hospital Affiliated to Jiangsu University from June 2008 to August 2013 was conducted. Nursing efficacy and safety were evaluated according to nursing methods and postoperative HSS score. Results All 82 patients were followed up for 12 to 23 months (mean, 19.5 ± 5.8) months. All patients achieved bony union. The healing time ranged from 11 to 19 weeks (mean, 14.5 ± 3.4) weeks. During follow-up, no broken staples, loosening of the steel plate, injury of the common peroneal nerve and deep vein thrombosis were found. At the last follow-up, according to the HSS score: excellent in 40 cases, good in 34 cases, fair in 5 cases and poor in 3 cases, the excellent and good rate was 90.24%. In postoperative complications: 4 cases of deep infection, superficial infection in 3 cases. Seven patients achieved complete clinical debridement, clinical treatment of negative pressure closed drainage (VSD) and flap or muscle flap metastases. Conclusion For the treatment of tibial plateau fractures, perioperative quality nursing is an effective guarantee for the prevention and treatment of surgical complications and complications. It can improve the excellent treatment rate of patients and is worthy of clinical promotion.