创伤性骨髓炎患者术后引流液中抗生素浓度的动态监测  

Dynamic monitoring research of local antibiotic concentration in postoperative drainage tissue fluid of traumatic osteomyelitis

作　　者：董宇[1,2] 沈立锋[1,2] 吴人杰[1,2] 倪竹南[3] 奚伟星[1,2] 张春[1,2] 章建民[1,2] 寿旦[1,2] 

机构地区：[1]浙江省中医药研究院 [2]浙江省立同德医院,杭州310007 [3]浙江省疾病预防控制中心理化检验所,杭州310051

出　　处：《中国临床药学杂志》2013年第5期293-296,共4页Chinese Journal of Clinical Pharmacy

基　　金：浙江省科技厅公益性技术应用研究(编号2011C23044);浙江省医药卫生科技计划(编号2012KYA035)

摘　　要：目的通过检测创伤性骨髓炎术后引流液中万古霉素与妥布霉素的含量,优化创伤性骨髓炎局部抗生素给药剂量。方法采用HPLC法,测定临床创伤性骨髓炎术后引流液中的万古霉素含量;采用离子色谱法,测定引流液中妥布霉素的含量。通过对22例给予不同剂量抗生素病例的检测,分析抗生素剂量与药物局部浓度的关系。结果创伤性骨髓炎患者术后引流液中万古霉素浓度随植入剂量的减少而降低;给予200mg万古霉素硫酸钙或40mg妥布霉素硫酸钙,局部药物浓度能够达到并超过有效抑菌浓度。结论建立的含量测定方法能够用于药物局部浓度监测,为创伤性骨髓炎抗生素给药剂量优化提供实验依据;万古霉素最佳给药剂量尚待进一步研究。AIM To determine the concentration of vancomycin and tobramycin from the drainage tissue fluid fol-lowing surgery for traumatic osteomyelitis respectively and optimize the antibiotic doses for traumatic osteomyelitis. METHODS The content of vancomycin from the drainage in clinical cases was determined by HPLC method and the content of tobramycin from the drainage was detennined by ion chromatography method. The 22 patients given different doses of antibiotics were detected to analyze the relationship between the antibiotic dose and local drug concentration. RESULTS The concentration of vancomycin solution was reduced with the decrease of implantation dose in drainage from patients with traumatic osteomyelitis surgery. When flap transplantation combined with 200 mg vancomycin calcium sulfate or with 40 mg tobramycin calcium sulfate in patients, the local drug concentration can reach and exceed the effective in-hibitory concentration. CONCLUSION The method can be used for monitoring the local drug concentration and provid- ing experimental basis for antibiotic dose optimization of traumatic osteomyelitis. The optimal dose of vancomycin remains to be further studied.

关 键 词：创伤性骨髓炎 局部药物浓度 万古霉素 妥布霉素 

分 类 号：R681.2[医药卫生—骨科学]