载药医用硫酸钙局部植骨与单纯病灶清除治疗骶髂关节结核的效果比较  

Comparison of the effect of medical calcium sulfate local bone graft and simple focus debridement for the treatment of joint tuberculosis

作　　者：李硕[1] 高建国[1] 张贺龙[1] 刘威[1] 岳世元 贾晨光[1] 王淑红 

机构地区：[1]河北省胸科医院骨科,石家庄050041 [2]河北省计划生育研究所

出　　处：《中国综合临床》2016年第5期412-416,共5页Clinical Medicine of China

基　　金：河北省卫计委指令性课题项目（20130127）

摘　　要：目的探讨病灶彻底清除术后应用混合有注射用利福平的医用硫酸钙（Osteoset）人工骨局部植骨治疗骶髂关节结核与单纯病灶清除术的临床效果。方法2005年5月至2010年8月，我们治疗骶髂关节结核患者48例，其中21例行单纯病灶清除术（对照组），余27例行病灶彻底清除术后用载有注射用利福平的Osteoset人工骨植骨融合术（植骨组），观察两组患者局部伤口愈合情况，有无不良反应，定期行骨盆x线片和CT扫描，对手术时间、术中出血量和术后6、12、18个月植骨融合率、Majeed评分优良率进行比较。结果术后48例患者获随访，两组患者手术时间、术中出血量比较差异均无统计学意义（P均〉0．05）；植骨组术后6个月融合率为33．33％（9／27），术后12个月为88．90％（24／27），术后18个月为96．30％（26／27）；对照组术后6个月融合率为4．76％（1／21），术后12个月为23．81％（5／21），术后18个月为42．85％（9／21），两组比较差异均有统计学意义（x2值分别为5．85、20．92、15．90，P均〈0．05）。末次随访Majeed骨盆评分植骨组优良率为100％（27／27），对照组为76．19％（16／21），差异有统计学意义（X2=7．18，P〈0．05）。结论载有利福平的Osteoset人工骨在骶髂关节结核植骨融合术中可以有效补充植骨量，与单纯行病灶清除术相比术后并发症少，达到骨性愈合的时间较短。Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rffampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis, and compare with debridement alone. Methods From May 2005 to August 2010, 48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province. Among them, 27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection （Grafting group ）, and 21 case were treated with radical debridement only（ Control group）. The local wound healing, adverse reactions and regular imaging examination （pelvic X-ray and CT scan） were observed ,and the surgical time, the intraoperative blood loss, postoperative 6 months and 12 months, 18 months bone graft fusion rate, and Majeed scoring resuhs of the patients were recorded and statistically analyzed. Results All patients were followed up from 20 to 30 months with an average of 24 months. There was no significant difference in terms of surgical time and operative bleeding between the two groups（P〉0. 05 ）. The rate of bone fusion in grafting group was 33.33% （9/27） of 6 months after operation, 88.9% （24/27） of 12 months after operation, and 96. 3% （26/27） of 18 months after operation. While that in control group was 4. 76%（1/21） of 6 months after operation,42. 85%（9/21） of 12 months after operation,and 42. 85% （9/21） of 18 months after operation. The differences of these parameters between the two groups were significant（ X2= 5.85,20. 92,15.90 ;P〈0. 05）. According to Majeed scoring system, the excellent and good rates were 100% （ 27/27 ） in grafting group, 76. 19% （ 16/21 ） in control group, the difference was statistically significant（ x2= 7.18 P〈0.05）. Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sa

关 键 词：骶髂关节 结核 医用硫酸钙 骨移植 植骨融合 

分 类 号：R687.3[医药卫生—骨科学]