| 李树亮,陈 峰,潘 奇,李 健,张雪涛.llizarov骨搬运技术治疗胫骨骨缺损的疗效及术后延迟愈合或不愈合的影响因素分析[J].,2022,(6):1151-1155 |
| llizarov骨搬运技术治疗胫骨骨缺损的疗效及术后延迟愈合或不愈合的影响因素分析 |
| Curative Effect of Llizarov Bone Transport Technique in the Treatment of Tibial Bone Defect and Analysis of the Influencing Factors of Postoperative Delayed Healing or Nonunion |
| 投稿时间：2021-07-25 修订日期：2021-08-21 |
| DOI：10.13241/j.cnki.pmb.2022.06.032 |
| 中文关键词: llizarov骨搬运技术 胫骨骨缺损 疗效 延迟愈合或不愈合 危险因素 |
| 英文关键词: Llizarov bone transport technology Tibial bone defect Curative effect Delayed healing or nonunion Risk factor |
| 基金项目:山东省自然科学基金项目（ZR2019MH097） |
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| 中文摘要: |
| 摘要 目的：探讨 llizarov骨搬运技术治疗胫骨骨缺损的疗效及术后延迟愈合或不愈合的影响因素分析。方法：选取 2016年 6月-2020年 10月本院收治的 90例胫骨骨缺损患者为研究对象，患者均给予 llizarov骨搬运技术治疗。对患者的手术效果指标、并发症发生率进行记录统计。并对患者进行门诊随访观察，统计患者延迟愈合或不愈合的发生情况，据此将患者分为愈合组和延迟愈合或不愈合组。采用单因素及多因素 Logistic回归分析患者术后延迟愈合或不愈合发生的影响因素。结果：患者住院时间为(12.11± 2.98)d、开始负重时间为(45.39± 7.78)d、完全负重时间(76.41± 11.23)d。患者术后并发症发生率为 8.89%(8/90)。经随访观察，共有 29例患者出现术后延迟愈合或不愈合，发生率为 32.22%（29/90）。而延迟愈合或不愈合组患者的伤口感染、合并软组织损伤、合并腓骨骨折、术后过早活动及有吸烟史的人数占比高于愈合组患者(P<0.05)。经多因素 Logistic回归分析显示：伤口感染、合并软组织损伤、合并腓骨骨折、术后过早活动、有吸烟史是患者术后延迟愈合或不愈合的危险因素(P<0.05)。结论：llizarov骨搬运技术治疗胫骨骨缺损的疗效较好，患者的手术时间短、术中失血量少、住院时间、开始负重时间均较短，并发症发生率低，治疗安全性较好，但患者易出现术后延迟愈合或不愈合现象，可能与伤口感染、合并软组织损伤、合并腓骨骨折、术后过早活动、吸烟史有关。 |
| 英文摘要: |
| ABSTRACT Objective: To study the curative effect of llizarov bone transport technique in the treatment of tibial bone defect and analysis of the influencing factors of postoperative delayed healing or nonunion. Methods: From June 2016 to October 2020, 90 patients with tibial bone defect who were treated in our hospital were selected as the research objects, and all patients were treated with llizarov bone transport technique. The operation effect index and complication rate were recorded and counted. And the outpatient follow-up observation of patients, the patients with delayed healing or nonunion was counted. The patients were divided into healing group and delayed healing or nonunion group. The clinical data of the two groups were compared and analyzed. The risk factors of postoperative delayed healing or nonunion of patients were analyzed by univariate analysis and multivariate Logistic regression analysis. Results: The hospitalization time was(12.11± 2.98) d, the starting weight-bearing time was(45.39± 7.78) d, and the complete weight-bearing time was (76.41 ± 11.23) d. After follow-up observation, 29 patients had postoperative delayed healing or nonunion, the incidence rate was 32.22%. The incidence of wound infection, combined soft tissue injury, combined with fibula fracture, postoperative premature activity and smoking history in the delayed healing or nonunion group were higher than those in healing group(P<0.05). Logistic multiple regression analysis showed that wound infection, soft tissue injury, combined with fibula fracture, postoperative premature activity and smoking history were risk factors for delayed healing or nonunion (P<0.05). Conclusion: Llizarov bone transport technique has a good efficacy in the treatment of tibial bone defect, with short operation time, less intraoperative blood loss, shorter hospital stay, shorter weight-bearing start time, low complication rate, and better treatment safety. However, patients are prone to delayed healing or nonunion after surgery. It may be related to wound infection, soft tissue injury, fibula fracture, premature postoperative activity and long-term smoking. |
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