糖尿病合并慢性骨髓炎诊疗进展  

Advances in Diagnosis and Treatment of Chronic Osteomyelitis Complicated with Diabetes Mellitus

作　　者：孙玉芝[1] 张朝晖[1] 马静[1] 

机构地区：[1]天津中医药大学第二附属医院糖尿病足科,天津300150

出　　处：《辽宁中医杂志》2015年第11期2249-2251,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273759)

摘　　要：糖尿病患者伤口难愈合已成为近年来治疗的一大难题,其中糖尿病合并骨髓炎成为影响伤口愈合的主要因素。早期诊断是治疗的关键,常常借助X线、核磁发现骨质破坏与骨质硬化、死骨等。临床治疗上方法多样,既包括传统中医"药捻疗法""拖线、挂线疗法""引流法","中医祛腐清创法""中药熏洗"等外治法,补肾壮骨填髓内服中药;还包括外科清创手术治疗、抗生素局部外用,清创后VSD的使用以及生物清创等多种治疗方法。要想有效地治疗糖尿病合并慢性骨髓炎,必须早发现,早诊断,早治疗。正确掌握清创的时机,合理清除死骨,而又不造成组织的过多损伤,佐以中药口服壮骨填髓,扶助正气,增强免疫力,同时选择敏感的抗菌素静点是治疗骨髓炎的关键。Diabetic wounds difficult to heal has become a big problem in the treatment of diabetes mellitus complicated with osteomyelitis,which becomes the main factor affecting the wound healing. Early diagnosis is the key to the treatment,often with the help of X- ray or NMR which can find the bone destruction and bone sclerosis,dead bone,etc. Clinical treatment methods include traditional Chinese medicine twisting therapy and dragging line,thread drawing therapy,drainage,Chinese medicine debridement,Chinese herbal fumigation and washing and other external treatments as well as Bushen Zhuanggu Tiansui internal medicine. It also includes surgical debridement operation treatment,topical antibiotics,debridement after VSD and biological debridement and other treatment methods. Effective treatment of diabetes mellitus with chronic osteomyelitis depends on early discovery,early diagnosis and early treatment. Correctly grasp the debridement time,reasonable to remove the dead bone,without causing too much damage tissue,combined with Zhuanggu Tiansui traditional Chinese medicine,supporting the healthy Qi,enhancing the immunity,also choosing the sensitive antibiotic static is the key point of the treatment of osteomyelitis.

关 键 词：糖尿病 慢性骨髓炎 治疗 

分 类 号：R587.1[医药卫生—内分泌] R681.2[医药卫生—内科学]