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目的 观察红花黄色素在距骨颈Ⅲ型骨折治疗中的疗效.方法 2013年9月至2016年3月采用经外踝低位截骨入路带血管蒂骰骨瓣移植治疗距骨颈骨折(HawkinsⅢ型)22例,其中,试验组11例,术后静脉应用红花黄色素,2次/d,连续12d.观察病人围术期D2聚体水平变化、术后平均住院日及骨折愈合、踝关节功能恢复状况.结果 试验组术后D2聚体水平迅速升高,第3d达峰值,之后快速下降,术后第l0dD2聚体水平明显低于术前;与对照组比较,术后第1,3d D2聚体水平明显升高;第7,10d则减低,两组间比较差异有统计学意义(P＜0.05).试验组术后平均住院日(13.53±1.67)d小于对照组(16.36 ±2.01)d,差异有统计学意义(P＜0.01).病例均获随访(9个月～4年),平均1.9年,骨折均愈合,7例发生距骨缺血性坏死(试验组3例,发生率27.27％;对照组4例,发生率36.36％),8例轻度踝及距下关节炎(两组各4例,发生率均为36.36％),踝关节功能按照Hawkins标准评定:优良率为试验组90.91％,对照组81.82％,两组比较差异无统计学意义(P＞0.05).结论 经外踝低位截骨入路带血管蒂骰骨瓣移植术结合红花黄色素治疗距骨颈Ⅲ型骨折,能较大程度减少创伤性关节炎及距骨缺血性坏死的发生.红花黄色素有抗血栓,降低D2聚体水平,减轻血液高凝状态,改善血液循环的作用,有助于缩短术后平均住院日;而本术式能有效保护并重建距骨血供,是恢复踝关节功能、减少距骨缺血率的重要因素.“,”Objective To evaluate the clinical effect of saffloryellow in the therapy of talarneck fractures.Methods From september 2014 to march 2016,22 patients of tatarneck fractures (Hawkins typeⅢ) were treated by open reduction,internal fixation using low-position external malleolus osteotomy approach and transposition of cuboid bone-flap with the laternal tarsal artery.Saffloryellow was used by intravenous infusion twice a day for 12 days after the operationimmediately in the test group.The levels of plasma Ddimerinperioperative period and theduration in hospital after operation were observed.The clinical effects of bone healing and the ankle and subtalar joint functional recovery were analyzed after operation.Results The postoperative levels of Ddimer increased rapidly and reached the peak on 3st day,then gradually decreased with time in the test group.The Ddimer level in the test group on 1 st and 3rd day after operation were apparently higher than those of the control group (P ＜0.05);On 7th and 10th day after operation were obviously lower than those of the control group (P ＜ 0.05).There was a statistical significant difference of the duration in hospitalafter operation between the test group (13.53 ± 1.67)d and control group (16.36-± 2.01) d (P ＜ 0.01).All the patients were followed up,ranged from 0.75 to 4years,average 1.9years.No postoperative non-union,the avascular necrosis of the talus was seen in 7 cases on radiographies(3 in the test group,4 in the control group),traumatic arthritis(mild) were occurred in8 cases (4 in each group).According to Hawkins evaluation standards,the total rate of being excellent and goodin the test group was 90.91％ (10/11)compared to 81.82(9/11) inthecontrol group (P ＞ 0.05).Conclusion The operative therapy associated with saffloryellow was a better method to treat talarneck fractures(Hawkins type Ⅲ).It can effectively decrease the avascular necrosis and traumatic arthritis of the talus.Saffloryellow has an definitely antithrombotic effectsby declining the blood viscosity and the Ddimerlevels,canimprove the circulation and shorten thehospitalstays.This operation can preserve the residual vessels and rebuild the blood supply of talus,which plays a key role in the treatment of talarneck fractures.