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[目的]探讨人类免疫缺陷病毒(human immunodeficiency virus,HIV)阳性青年男性患者四肢闭合骨折行切开复位钢板螺钉内固定术后切口延迟愈合发生率,以及探究这类患者术后切口延迟愈合的危险因素。[方法]对2012年5月~2014年12月于本院因明确外伤所致四肢闭合性骨折并行切开复位钢板螺钉内固定术的52例HIV阳性青年男性患者进行回顾性分析。根据患者切口愈合情况分为切口延迟愈合组和正常愈合组,分别记录患者年龄,骨折部位,切口长度,切口缝合方式,手术时间,外周血CD4+T细胞计数,血红蛋白,血清白蛋白等,记录这类患者术后切口延迟愈合的发生率,比较两组间以上各因素的差异性,探究与切口延迟愈合相关的危险因素。[结果]52例患者均成功接受切开复位钢板螺钉内固定术,手术顺利,未见明显手术及麻醉并发症发生。术后切口延迟愈合的发生率为26.92%(14例),其中发生切口裂开12例(23.07%),发生切口脂肪液化2例(3.85%)。与正常愈合组相比,延迟愈合组下肢骨折和皮内缝合的比率较高(下肢骨折78.57%vs 44.74%,皮内缝合71.43%vs 39.47%),切口相对较长[(7.79±1.80)cm vs(6.87±1.67)cm],术前外周血CD4~+T细胞计数<200 cells/mm~3的比率较高(21.43%vs 0%),外周血白细胞计数较低[(5.98±1.78)×10~9/L vs(7.30±1.21)×10~9/L],血清白蛋白水平较低[(34.07±3.60)g/L vs(38.53±4.32)g/L],血红蛋白水平较低[(100.43±9.62)g/L vs 107.08±9.34)g/L]。[结论]HIV阳性青年男性患者四肢闭合骨折行切开复位内固定术后切口延迟愈合的发生率为26.92%,且延迟愈合的发生与手术部位、切口长度、切口缝合方式、术前外周血CD4~+T细胞计数、白细胞计数、血红蛋白以及血清白蛋白水平等因素相关。
[Objective] To investigate the incidence of incision delayed union after open reduction and internal fixation of screws in the newly diagnosed male patients with human immunodeficiency virus (HIV) and explore the risk of postoperative incision delayed healing in these patients factor. [Methods] From May 2012 to December 2014, 52 HIV-positive young male patients undergoing open reduction and internal fixation with open reduction and closed fracture of the limbs due to definite trauma were retrospectively analyzed. Patients were divided into delayed incision healing group and normal healing group according to the incision healing status of patients. The patient’s age, fracture site, incision length, incision suture method, operation time, CD4 + T cell count, hemoglobin and serum albumin were recorded The incidence of postoperative incision delayed healing in these patients was compared between the two groups of different factors above to explore the risk factors associated with delayed incision healing. [Results] All the 52 patients were successfully treated with open reduction and internal fixation with screws, and the operation was successful. There was no obvious operation and complications of anesthesia. Postoperative incision delayed healing rate was 26.92% (14 cases), of which incision incision in 12 cases (23.07%), incision fat liquefaction in 2 cases (3.85%). Compared with the normal healing group, the rate of lower extremity fracture and intradermal suture was higher in delayed union group (78.57% vs 44.74% for lower extremity and 71.43% vs 39.47% for intradermal suture), and the incision was relatively longer (7.79 ± 1.80 cm (6.87 ± 1.67) cm]. The preoperative CD4 ~ + T cell count was higher than 200 cells / mm ~ 3 (21.43% vs 0%) and the peripheral blood leukocyte count was lower [(5.98 ± 1.78) vs (34.07 ± 3.60) g / L vs (38.53 ± 4.32) g / L], and the hemoglobin level was lower [(100.43 ± 9.62) g / L vs 107.08 ± 9.34) g / L]. [Conclusion] The incidence rate of delayed union after open reduction and internal fixation was 26.92%. The incidence of delayed union was similar to that of surgical site, incision length, incision suture method, preoperative peripheral blood CD4 ~ + T cell count, white blood cell count, hemoglobin and serum albumin levels and other factors.