唐智生

【摘要】 目的：观察中药外敷配合多层螺旋CT（Multislice CT，MSCT）处理技术指导对治疗跟骨骨折患者切开复位内固定的临床效果。方法：回顾性分析2016年1月-2017年6月本院收治的跟骨骨折患者67例的临床资料，按照治疗方法不同將其分为对照组32例（术前静脉滴注）和研究组35例（术前中药外敷），两组均行MSCT处理指导切开复位内固定术。比较两组术前8、12、24 h的肿胀缓解情况及疼痛程度（VAS评分）；比较两组术前准备时间、骨折愈合时间、住院时间及临床疗效。结果：研究组术前8、12、24 h的肿胀缓解率分别为37.14%、74.29%、97.14%，均高于对照组的12.50%、37.50%、62.50%（P<0.05）；研究组术前8、12、24 h的VAS评分、术前准备时间、骨折愈合时间、住院时间均明显少于对照组，比较差异均有统计学意义（P<0.05）；研究组总有效率为94.29%（33/35），高于对照组的75.00%（24/32），比较差异有统计学意义（P<0.05）。结论：中药外敷治疗配合MSCT后处理技术指导在跟骨骨折患者切开复位内固定时，能够有效改善患者伤口肿胀程度，缩短术前准备时间，令患者痛感减轻，加快骨折愈合时间，临床治疗效果显著。

【关键词】 中药外敷； MSCT； 跟骨骨折； 切开复位内固定； 临床效果

【Abstract】 Objective：To observe the clinical effect of Chinese medicine external application treatment combined with Multislice CT（MSCT） post-processing technique in guidance of calcaneal fractures incision reduction internal fixation.Method：The clinical data of 67 patients with calcaneal fracture treated in our hospital from January 2016 to June 2017 were retrospectively analyzed.According to the different treatment methods，they were divided into 32 cases of control group（preoperative intravenous drip） and 35 cases of study group（preoperative Chinese medicine external application），they were treated with MSCT post-processing technique in guidance of calcaneal fractures incision reduction internal fixation.The swelling remission and the degree of pain（VAS score） at 8，12 and 24 h before operation between two groups were compared，the preoperative preparation time，fracture healing time，hospitalization time and clinical effect between two groups were compared.Result：The swelling remission rate of 8，12，and 24 h before operation in study group were 37.14%，74.29% and 97.14% respectively，which were higher than 12.50%，37.50% and 62.50% in control group（P<0.05）.VAS score，preoperative preparation time，fracture healing time and hospitalization time in study group at 8，12 and 24 h before operation were significantly less than those of control group，the differences were statistically significant（P<0.05）.The total effective rate of study group was 94.29%（33/35），which was higher than 75.00%（24/32） of control group，the difference was statistically significant（P<0.05）.Conclusion：Chinese medicine external application treatment combined with MSCT post-processing technique in guidance of calcaneal fractures incision reduction internal fixation，can effectively improve the degree of wound swelling，shorten the preparation time before operation，reduce the pain of patients，accelerate the time of fracture healing，and the clinical effect is remarkable.

【Key words】 Chinese medicine external application； MSCT； Calcaneal fracture； Incision reduction internal fixation； Clinical effect

First-authors address：Zhangmutou Peoples Hospital，Dongguan 523000，China

doi：10.3969/j.issn.1674-4985.2018.05.034

跟骨骨折多数是由于从高处跌落足跟着地所导致的一种跗骨骨折，骨折程度与跌落的高度、地面的质地及患者的体重等因素相关[1]。临床研究显示，跟骨骨折的发生情况较多，在跗骨骨折患者中约占60%的发生率[2]。跟骨骨折患者的足跟部发生剧烈疼痛，并伴有严重肿胀和瘀斑，患者足跟无法着地行走，按压骨折疼痛难忍。人体足跟骨属于骨松质组织，血供丰富，骨不连者极为少见，骨折后复位不良者常发生后遗性骨关节炎或足跟负重疼痛现象。临床跟骨骨折的类型多样，病理解剖分型复杂，其中70%为关节内骨折患者，其余属于关节外骨折，若患者进行复位固定治疗效果不佳，在术后易发生跟骨急性及骨突出等并发症，患者足部将长期饱受疼痛折磨，严重影响日常生活[3-4]。目前，国内外逐渐开展CT影像技术处理指导骨折的诊断和治疗，能够避免X射线平面影像片因多器官重叠而发生漏诊骨折的情况。……