负压封闭引流结合骨水泥抗生素链珠治疗胫腓骨骨折术后早期感染的研究  

Effect of vacuum sealing drainage combined with bone cement antibiotic chain beads on treatment of early infections after tibia and fibula fracture surgery

作　　者：李新霞[1,2] 孙雪生[1,2] 

机构地区：[1]泰山医学院附属莱芜医院 [2]莱芜市人民医院骨二科,山东莱芜271100

出　　处：《中华医院感染学杂志》2013年第14期3400-3401,共2页Chinese Journal of Nosocomiology

基　　金：莱芜市科学技术局科研基金(11A61320039)

摘　　要：目的探讨负压封闭引流结合骨水泥抗生素链珠在治疗胫腓骨骨折术后早期感染的效果,总结有效的处理措施,预防及减少临床并发症的发生。方法回顾性分析2009年8月-2012年8月入住医院经病理学诊断为胫腓骨骨折的32例患者临床资料,采用骨水泥抗生素链珠外加负压封闭引流等方法加以治疗,其中21例患者行保留内固定装置进行治疗,剩余11例患者行更换外固定支架进行治疗。结果 32例患者中有29例患者于术后12～36个月,平均为21个月获得随访,所有感染均得到控制,其中28例患者无复发,骨折最终获得骨性愈合,骨折愈合时间为4～9个月,平均为6.7个月,复发率极低,仅为3.45%;随访的29例患者中,仅1例出现畸形愈合,无其他并发症出现。结论负压封闭引流结合骨水泥抗生素链珠治疗胫腓骨骨折术后早期感染的发生率较低,是一种治疗胫腓骨骨折术后早期感染的有效方法,应该在临床上加以推广并应用。OBJECTIVE To investigate the effect of vacuum sealing drainage combined with bone cement antibiotic chain beads on treatment of early infections after tibia and fibula fracture surgery and propose effective treatment measures so as to reduce the incidence of clinical complications.METHODS The clinical data of 32 cases of patients who were enrolled in the hospital and were diagnosed with tibia and fibula fractures through pathology from Aug 2009 to Aug 2012 were retrospectively analyzed,all the patients were treated with bone cement antibiotic chain beads plus vacuum sealing drainage,including 21 cases of patients who were treated with the retention internal devices and the rest of 11 cases who were treated with the replacement of external fixator.RESULTS Of totally 32 cases of patients,29 patients were followed up 12-36 months after the surgery with the mean time of the follow-up of 21 months,and the infections were under control,of which 28 patients were without recurrence,and the fractures eventually acquired the bone healing,with the fracture healing time of 4 to 9 months（mean 6.7 months）,the recurrence rate was very low,only 3.45%.Of 29 cases of follow-up patients,there was only one case with malunion and no case with other complications.CONCLUSIONAs the vacuum sealing drainage combined with bone cement antibiotic chain beads is used after the tibia and fibula fractures surgery,the incidence of early infections is relatively low,it is an effective way to treat the early infections after the tibia and fibula fractures surgery and is worthy to be promoted in the hospital.

关 键 词：负压封闭引流 骨水泥 抗生素链珠 胫腓骨骨折 

分 类 号：R687.3[医药卫生—骨科学]