骨折内固定术后感染的治疗方法与时机的选择  

An investigation on therapeutic measures and optimal opportunity for treating POI following internal fixation of fracture

作　　者：杨佐明[1] 戴士峰[1] 魏亚恒[1] 张艳蕊[1] 

机构地区：[1]河北省唐山市第二医院骨病科,063000

出　　处：《中国骨与关节损伤杂志》2012年第11期1006-1008,共3页Chinese Journal of Bone and Joint Injury

基　　金：2011年度河北省科学技术研究与发展计划自筹经费资助项目(112761164)

摘　　要：目的探讨骨折内固定术后感染的治疗方式与时机选择，以提高治疗效果。方法对自2004年4月一2010年lO月收治的骨折内固定术后感染病程超过3个月、未改变原固定方式的62例的临床资料进行回顾性分析研究。原内固定方式：髓内针34例，钢板15例，混合固定13例。骨折均愈合或基本愈合，在取出内固定物、彻底清创、脉冲冲洗的基础上采用自行研制的双阀门侧孔式灌洗管灌洗术进行治疗。结果经术后1～3年随访，62例术后切口均一期愈合，未出现关节功能障碍及感染复发。结论在感染可以控制的情况下，保留原内固定物，待骨折愈合后再根治感染可以明显缩短治疗时间和降低关节功能障碍等并发症。Objective To explore the therapeutic measures and optimal opportunity for treating postoperative infection （POI） following internal fixation of fracture so as to improve the therapeutic effects. Methods A systematic review was conducted on the 62 patients, admitted between April 2004 and October 2010, with POI following internal fixation of fracture （infection course exceeded 3 months, and the original fixation manners were not altered）. For the original fixation manners, 34 eases were treated with medullary pins, 15 with steel plates, and the other 13 with hybrid fixation. All the fractures were healed or preliminarily healed. In addition to removal of internal implants, thorough debridement and pulsed irrigation, the patients also received lavage with a double-valve lateral-hole lavage tube that novelly invented by us. Results During 1 to 3 years postoperative following-up, the wounds of 62 patients were all primarily healed, without joint dysfunction and recurrent infection. Conclusion If infection is under control, the original internal implants can be retained, until fracture is healed. A reasonably postponed anti-infection could significantly reduce the duration of therapeutic course and the risks of various complications, such as joint dysfunctions and etc.

关 键 词：骨折内固定 晚期感染 骨折术后感染 灌洗术 

分 类 号：R683.420.5[医药卫生—骨科学]