【摘要】：研究目的脛腓骨開(kāi)放性骨折患者,由于小腿前內(nèi)側(cè)無(wú)肌肉覆蓋的解剖特點(diǎn),患處軟組織受損,骨膜破壞,血液流通阻塞不暢,血液供應(yīng)差,容易引起后期發(fā)生骨折延遲愈合或不愈合等并發(fā)癥。從中醫(yī)角度,早中期應(yīng)活血化瘀、消腫止痛、續(xù)筋接骨。我院自制中藥制劑骨傷復(fù)元湯,探究其在脛腓骨開(kāi)放性骨折骨愈合過(guò)程中的作用效果,并分析其臨床意義,希望能為脛腓骨開(kāi)放性骨折患者疾病的治療康復(fù)提供意見(jiàn)。研究方法1.依據(jù)臨床科研方法學(xué),就山東中醫(yī)藥大學(xué)附屬文登整骨醫(yī)院2014年1月至2015年1月份就診的100例脛腓骨開(kāi)放性骨折的患者資料進(jìn)行分析和研究。2.采用隨機(jī)分類(lèi)的方式,將100例患者隨機(jī)抽取號(hào)碼牌,奇數(shù)分為觀(guān)察組,偶數(shù)分為對(duì)照組。兩組患者入院后急診清創(chuàng),都采用臨床常規(guī)的外固定架進(jìn)行固定,術(shù)后均給予抗生素常規(guī)消炎治療。3.觀(guān)察組在骨折術(shù)后早、中期能進(jìn)食時(shí)開(kāi)始服用我院自制中藥骨傷復(fù)元湯,早晚各1/2劑,共服用4周。方以活血化瘀、涼血消腫止痛、祛瘀生新藥為主;對(duì)照組早、中期靜滴注射用復(fù)方骨肽作為對(duì)比。晚期兩組都口服相同的接骨藥。4.比較兩組患者術(shù)后的治療情況,同時(shí)術(shù)后隨訪(fǎng)患者4~10個(gè)月,平均6個(gè)月。同時(shí),觀(guān)察對(duì)照組與觀(guān)察組患者的臨床癥狀消失時(shí)間、愈合時(shí)間、血液動(dòng)力學(xué)角度以及并發(fā)癥等,記錄結(jié)果并采用統(tǒng)計(jì)學(xué)的方法進(jìn)行分析處理。研究結(jié)果1.觀(guān)察組患肢腫脹和疼痛消失時(shí)間能夠明顯縮短。2.觀(guān)察組患者的PT和APTT延長(zhǎng),血清中纖維蛋白原含量(FIB)降低,能夠改善血液粘稠度,防止下肢靜脈血栓形成。3.觀(guān)察組患肢的愈合時(shí)間能夠明顯縮短,骨不愈合率降低。研究結(jié)論脛腓骨開(kāi)放性骨折的治療以患者術(shù)后容易出現(xiàn)骨折延遲愈合或不愈合、下肢靜脈血栓形成等并發(fā)癥較多,以中醫(yī)學(xué)上的觀(guān)點(diǎn),在骨折早期,瘀阻經(jīng)絡(luò),不通則痛,應(yīng)活血化瘀、消腫止痛;在骨折中期祛瘀生新,續(xù)筋接骨;在骨折后期補(bǔ)益肝腎、促進(jìn)骨折愈合。活血化瘀、消腫止痛、祛瘀生新,續(xù)筋接骨這是中醫(yī)治療開(kāi)放性骨折早中期的主要方法。總結(jié)來(lái)說(shuō),在骨折早、中期應(yīng)用活血化瘀、消腫止痛、祛瘀生新藥物對(duì)于治療開(kāi)放性骨折能夠縮短腫脹、疼痛時(shí)間,能夠明顯縮短骨折愈合的時(shí)間,降低術(shù)后下肢靜脈血栓形成,應(yīng)當(dāng)引起廣大醫(yī)學(xué)衛(wèi)生工作者的關(guān)注。
[Abstract]:Objective to study the dissection of the open fracture of the tibia and fibula, due to the dissection of the medial calf medial muscle, the damage of the soft tissue of the affected area, the destruction of the periosteum, the poor circulation of the blood, the poor blood supply, and the complications such as delayed union or non Union in the later period. To explore the effect of its effect on bone healing process of open fracture of tibia and fibula, and analyze its clinical significance, and hope to provide advice for the treatment and rehabilitation of the patients with open fracture of tibia and fibula. Research method 1. according to the clinical science research law, the Wendeng whole affiliated to the Shandong University of Traditional Chinese Medicine. The data of 100 cases of open fracture of tibia and fibula in bone hospital from January 2014 to January 2015 were analyzed and studied..2. was randomly divided into 100 cases, the odd number was divided into the observation group and the even number was divided into the control group. The two groups of patients were treated for acute debridement after admission to the hospital, and the clinical routine external fixators were used. After the operation, the.3. observation group was given antibiotics routine antiphlogistic treatment group after the fracture operation early after the fracture operation and the middle period can be taken to take our home made Chinese medicine bone injury compound soup. Early and late, each 1/2 agent was taken for 4 weeks. In the two groups, the two groups were taken orally with the same bone medicine to compare the treatment of the two groups after the operation, and the patients were followed up for an average of 6 months for 4~10 months. At the same time, the clinical symptoms disappeared, the healing time, the hemodynamic angle and the complications were observed in the control group and the observation group, and the results were recorded and the statistical methods were used for the score. 1. observation group 1. observation group affected limb swelling and pain disappearance time can obviously shorten the PT and APTT prolongation of the patients in the observation group, the decrease of serum fibrinogen content (FIB), improve the blood viscosity, prevent the healing time of the affected limb in the.3. observation group of the lower extremities to be significantly shortened and the bone nonunion rate lower. Conclusion the treatment of open fracture of tibia and fibula is prone to delayed union or nonunion after operation, and more complications such as the formation of venous thrombosis in the lower extremities. Promoting the liver and kidney to promote the healing of fracture. It is the main method of traditional Chinese medicine to treat open fracture in the middle and middle period of traditional Chinese medicine. It is the main method of Chinese medicine to treat open fracture in the early middle period. The time of fracture healing and the reduction of postoperative venous thrombosis of lower extremity should arouse the attention of medical workers.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R274.1

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