胫骨平台及踝部骨折内外固定后低毒性感染伴窦道形成:口服利福平、环丙沙星加皮瓣移植修复的效果  

Hypotoxicity infection with sinus formation after tibial plateau and ankle fracture fixation: effects of orally taking rifampicin and ciprofloxacin with transfer of skin flap

作　　者：张波[1] 赵金龙[1] 欧阳振[1] 于洋[1] 吴涛[1] 宋永才[1] 李伍健 刘继超[1] 尹伟[1] 杨立峰[1] 刘丰虎[1] 杨斌辉[1] 

机构地区：[1]西安交通大学医学院附属三二○一医院骨科,陕西省汉中市723000

出　　处：《中国组织工程研究》2014年第44期7077-7082,共6页Chinese Journal of Tissue Engineering Research

基　　金：汉中市科技发展计划基金(2011(二)13)~~

摘　　要：背景:近年国内外对骨折内固定后低毒性感染的报道有较多的文献,但对术后慢性低毒性感染内固定取出是否是必须的报道不一,没有固定的疗效判断标准,导致治疗方法结论不确切。目的:观察口服利福平、环丙沙星加皮瓣转移对胫骨平台及踝部骨折内外固定后低毒性感染伴窦道形成的疗效。方法:收集2005年9月至2012年12月收治的胫骨平台及踝部骨折内外固定后低毒性感染患者56例,其中治疗组30例采用口服环丙沙星+利福平+皮瓣转移治疗,对照组26例采用常规静点抗生素+局部清创内固定取出治疗。两组均完成3-6个月的疗程,每1-3个月复查血沉、肝肾功及影像学指标评估疗效。结果与结论:随访6-24个月,治愈、好转患者无复发。治疗组24例治愈,4例好转,2例无效,总有效率为93%;对照组11例治愈,6例好转,无效9例,总有效率为65%。经χ2检验,治疗组疗效明显优于对照组(P<0.05)。提示口服利福平、环丙沙星加皮瓣转移对胫骨平台及踝部骨折内外固定后低毒性感染伴窦道形成有良好的修复效果。BACKGROUND：Recently, there are many documents al over the world reporting hypotoxicity infection after fracture internal fixation surgery, but reports are different on whether it is necessary for chronic hypotoxicity infection internal fixation removal post surgery. There are no fixed judgment criteria of curative effects, which leads to inexact conclusion of treatment method. OBJECTIVE：To observe the curative effects of taking rifampicin and ciprofloxacin with transfer of skin flap in the treatment of chronic hypotoxicity infection with sinus formation after fracture surgery on tibial plateau and ankle. METHODS：A total of 56 cases of chronic hypotoxicity infection after fracture surgery of tibial plateau and ankle were col ected from September 2005 to December 2012. 30 cases in the therapy group were treated with levofloxacin and rifampicin with transfer of skin flap. 26 cases in the control group were treated with conventional＆amp;nbsp;intravenous antibiotics with local debridement to remove internal fixation. In both groups, the course of disease was 3 to 6 months. The erythrocyte sedimentation rate, kidney function and radiographic indices were reviewed every 1 to 3 months, and curative effects were evaluated. RESULTS AND CONCLUSION：During the fol ow-up visit of 6-24 months, no recurrence happened to the cured and improved patients. In the therapy group, 24 cases were cured, 4 cases were improved, and 2 cases were invalid, with a total effective rate of 93%. In the control group, 11 cases were cured, 6 cases were improved and 9 cases were invalid with the total effective rate of 65%.χ2 test showed that therapeutic effects were significantly better in the therapy group than in the control group （P〈0.05）. These data indicated that rifampicin and ciprofloxacin with transfer of skin flap for chronic hypotoxicity infection with sinus formation after fracture surgery of tibial plateau and ankle showed good curative effects.

关 键 词：植入物 骨植入物 低毒性感染 窦道形成 骨折术后 利福平 环丙沙星 皮瓣转移 治疗 

分 类 号：R318[医药卫生—生物医学工程]