慢性骨髓炎的治疗  

Results in treatment of chronic osteomyelitis

作　　者：郭文键[1] 刘克[1] 庄桂炉[1] 郑钦洪[1] 

机构地区：[1]汕头大学医学院第二附属医院,广东汕头515031

出　　处：《中国热带医学》2005年第8期1695-1697,共3页China Tropical Medicine

摘　　要：目的探讨不同手术方法对慢性骨髓炎的治疗效果。方法对38例慢性骨髓炎患者进行治疗观察,其中彻底病灶清除残留骨腔大者,以肌瓣或肌皮瓣填塞5例,无大骨腔者闭合伤口抗菌素灌洗25例,Orr’s疗法5例,病骨切除3例。结果经随访1～15年,5例肌瓣填塞均I期愈合;灌洗25例,24例愈合,1例愈合2年后复发;病骨切除3例均I期愈合;Orr’s疗法在3～5个月愈合4例,1例跟骨术后1年仍有分泌物。结论彻底清除炎性病灶是治愈慢性骨髓炎的关键措施,跟骨病灶较难彻底清除,是未愈的主要原因。有大骨腔者肌瓣填塞,无大骨腔者灌洗治疗可1次愈合。Orr’s疗法,可在5个月内愈合,适于无肌瓣填塞的部位。Objective To study the results of chronic osteomyelitis treated by various operation. Methods There were 38 eases of bone lesions in which 14 femora, 16 in tibia, I in humeral, 3 in fibula, 1 in ealeanea, 2 in phalanx and 1 in eostae. The causes of osteomyelitis were haematogenous in 27 cases and infected open fracture in 11 eases. The duration osteomyelitis varied from 5 months to 60 years, Methods The lesion were thoroughly excised and filled by muscular flap or museulocutaneous in large bony cavity in 5 eases, irrigation with antibiotics in small bony cavity in 25 eases, Orr＇s operation in 5 cases and excision of phalanx in 3 cases. Results All eases were followed - up for from I to 15 years. All of 5 cases that filled by muscular flap were all cured in primary stage. 24 eases of irrigation method healed and 1 ease of fibula osteomyelitis relapsed 2 years later. There were 4 eases of Orr＇ s method healed in 3 - 5 months and one ease of ealeaneus did not heal until 1 year. The case of phalanx escision was healed. Conclusion Thoroughly excision of osteomyelitis is a key step in the treatment of chronic osteomyelitis. As for ealeaneus, it was difficult to clean away thoroughly, thus this was the of recurrence. Muscular flap filling was the choice of treatment for large bony cavity and irrigation for small bony cavity. Orr＇ s treatment may - be used at the site where muscular flap was not available and bone healing oceta-red with in 3 - 5 months.

关 键 词：慢性骨髓炎 手术治疗 效果 

分 类 号：R681.2[医药卫生—骨科学]