夹板固定和皮肤牵引在粗隆间骨折患者术前固定的效果比较

目的 比较夹板固定和皮肤牵引在粗隆间骨折患者术前固定的效果。方法 回顾分析我院粗隆间骨折患者66例,按照术前固定方式分成夹板组和牵引组,每组33例。夹板组患者术前采用夹板固定,牵引组患者术前采用皮肤牵引固定。通过视觉模拟评分法（VAS）记录患者舒适程度、疼痛程度和满意度。通过制动舒适度问卷（ICQ）评估患者在术前固定期间的舒适水平。记录所有患者术前并发症发生情况。结果 固定后15 min、1 h和2 h夹板组患者舒适评分均显著高于牵引组患者（P<0.05）。固定后1、2、3、4、5、6和7 d夹板组患者ICQ评分显著高于牵引组患者（P<0.05）。固定后15 min、1 h、2 h以及1、2、3、4和5 d夹板组患者疼痛评分显著低于牵引组患者（P<0.05）。固定后1、2、3、4、5、6和7 d夹板组患者满意度评分显著高于牵引组患者（P<0.05）。夹板组患者术前并发症总发生率显著低于牵引组患者（P<0.05）。结论 术前夹板固定较皮肤牵引可进一步减小粗隆间患者疼痛程度和并发症发生率,提高患者舒适度和满意度,值得在临床上推广。

Comparison of preoperative immobilization effect between splint and skin traction in intertrochanteric fracture patients

Objective To compare preoperative immobilization effect between splint and skin traction in intertrochanteric fracture patients. Methods 66 intertrochanteric fracture patients were retrospectively analyzed. 66 patients were assigned to the splint group and the traction group according to the preoperative immobilization method （n=33）. Patients in the splint group received splint immobilization preoperatively, and patients in the traction group received skin traction. Patients′ comfort, pain and satisfaction were recorded by visual analogue scale （VAS）. Immobilization Comfort Questionnaire （ICQ） was used to evaluate patients′ comfort during preoperative immobilization period. Results Comfort VAS scores were significantly higher in the splint group than those in the traction group 15 min, 1 h and 2 h after immobilization （P< 0.05）. ICQ scores were significantly higher in the splint group than those in the traction group from 1 d to 7d after immobilization （P< 0.05）. Pain VAS scores were significantly lower in the splint group than those in the traction group 15 min, 1 h, 2 h, 1 d, 2 d, 3 d, 4 d, 5 d, 6 d and 7 d after immobilization （P< 0.05）. Satisfaction VAS scores were significantly higher in the splint group than those in the traction group from 1 d to 7 d after immobilization （P< 0.05）. Incidence rate of preoperative complication was significantly lower in the splint group than those in the traction group （P< 0.05）. Conclusion Preoperative splint immobilization could decrease pain level and incidence rate of complication and increase comfort and satisfaction in intertrochanteric fracture patients, which is worth popularizing clinically.