航空航天医学杂志

目的 探讨外固定架结合负压引流术(vacuum sealing drainage, VSD)对小腿骨折合并严重软组织损伤(Soft Tissue Injury, STI)的疗效。方法 对本院2023年01月至2024年12月的102例小腿骨折合并严重STI患者进行回顾性分析，按治疗方法的不同分为对照组(外固定架治疗)与研究组(外固定架+VSD治疗),各51例。比较两组预后情况、炎症因子水平、疼痛程度及并发症发生率。结果 研究组伤口与骨折愈合时间分别为：(16.34±2.85)d、(94.32±8.56)d,短于对照组的(21.45±3.29)d、(105.55±10.21)d(P<0.05)。术后3月，研究组IL-6、hs-CRP、TNF-α分别为：(16.55±2.64)pg/ml、(8.92±1.65)mg/L、(9.36±1.34)pg/ml,低于对照组的(23.94±3.02)pg/ml、(12.63±2.14)mg/L、(14.33±2.58)pg/ml(P<0.05)。术前两组疼痛评分无显著差异(P>0.05);术后1月与2月，研究组疼痛评分低于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论 对小腿骨折合并严重STI患者予以外固定架结合VSD治疗，可促进其伤口与骨折愈合，缓解机体炎症反应，减轻躯体疼痛感，还可降低相关并发症发生风险。

Objective To investigate the efficacy of external fixation combined with vacuum sealing drainage(VSD) in the treatment of calf fractures with severe soft tissue injury(STI). Methods A retrospective analysis was conducted on 102 patients with leg fractures complicated with severe STI in our hospital from January 2023 to December 2024. They were divided into a control group(treated with external fixation) and a study group(treated with external fixation+VSD) according to different treatment methods, with 51 cases in each group. Compare the prognosis, levels of inflammatory factors, degree of pain, and incidence of complications between two groups. Results The healing time of wounds and fractures in the study group was(16.34±2.85) days and(94.32±8.56) days, respectively, which was shorter than the control group's(21.45±3.29) days and(105.55±10.21) days(P<0.05). Three months after surgery, the levels of IL-6, hs CRP, and TNF-α in the study group were(16.55±2.64) pg/ml,(8.92±1.65) mg/L, and(9.36±1.34) pg/ml, respectively, which were lower than those in the control group(23.94±3.02) pg/ml,(12.63±2.14) mg/L, and(14.33±2.58) pg/ml(P<0.05). There was no significant difference in pain scores between the two groups before surgery(P>0.05); At 1 and 2 months after surgery, the pain score in the study group was lower than that in the control group(P<0.05). The total incidence of complications in the study group was higher than that in the control group(P<0.05). Conclusions External fixation combined with VSD treatment can promote wound and fracture healing, alleviate inflammatory reactions, alleviate physical pain, and reduce the risk of related complications in patients with severe STI complicated by calf fractures.