不同成分骨水泥植入对胫骨慢性骨髓炎患者的临床疗效评价  

Clinical effect of implantation of different components of bone cement on treatment of chronic tibial osteomyelitis

作　　者：甘先民[1] 侯悦媚[1] 黄乙勇 黎行宙 符凯[1] GAN Xian-min HOU Yue-mei HUANG Yi-yong LI Hang-zhou FU Kai(Hainan Maternal and Child Health Hospital, Haikou, Hainan 570203, Chin)

机构地区：[1]海南省妇幼保健院小儿骨科,海南海口570203

出　　处：《中华医院感染学杂志》2017年第12期2763-2766,共4页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金面上资助项目(20168326)

摘　　要：目的探讨腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入对胫骨慢性骨髓炎的临床疗效。方法回顾医院2014年1月-2015年2月收治40例胫骨慢性骨髓炎患者的临床资料,根据治疗方案的不同,采用万古霉素硫酸钙骨水泥治疗22例患者为研究组,采用庆大霉素骨水泥(PMMA)治疗18例患者为对照组,两组均给予封闭负压引流以及腓肠神经营养血管皮瓣,观察比较两组治疗疗效以及感染控制情况。结果研究组治疗疗效优良率为95.45%,显著高于对照组72.22%,组间差异有统计学意义(P<0.05);研究组感染控制时间2~4.5个月,平均时间(1.9±0.6)个月,对照组感染控制时间3.5~5.5个月,平均时间(3.7±0.2)个月;研究组与对照组感染控制率分别为95.45%和72.22%,差异有统计学意义(P<0.05),感染病程分别为(10.2±3.1)个月和(9.9±3.3)个月(P<0.05)。结论腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入对胫骨慢性骨髓炎具有更加显著的疗效,患者控制感染所需时间短,并且对于软组织缺损较为严重的胫骨慢性骨髓炎疗效更佳,适合在临床上推广使用。OBJECTIVE To explore the clinical efficacy of sural neurovascular flap combined with implantation of vancomycin calcium sulfate bone cement in treatment of chronic tibial osteomyelitis.METHODS The clinical data of 40 patients with chronic tibial osteomyelitis who were treated in the hospital from Jan 2014 to Feb 2015 were retrospectively analyzed.According to the treatment plans,22 patients who were treated with vancomycin calcium sulfate bone cement were assigned as the study group,and 18 patients who were treated with gentamicin bone cement （PMMA） were set as the control group;both groups were given vacuum sealing drainage and sural neurovascular flap.The therapeutic effect and status of control of infection were observed and compared between the two groups of patients.RESULTS The rate of excellent and good therapeutic effect of the study group was 95.45%,significantly higher than 72.22% of the control group （P〈0.05）.The time of control of infection was 2-4.5 months in the study group,3.5-5.5 months in the control group;the mean time of control of infection was （1.9±0.6） months in the study group,（3.7±0.2） months in the control group.The rate of control of infection was 95.45% in the study group,72.22 % in the control group,and there was significant difference （P〈0.05）.The course of infection was （10.2±3.1） months in the study group,（9.9 ± 3.3） months in the control group （P〈0.05）.CONCLUSION Sural neurovascular flap combined with implantation of vancomycin calcium sulfate bone cement can achieve more significantly effect on treatment of the patients with chronic tibial osteomyelitis,with the time of control of infection short,and it has more significant curative effect on the chronic tibial osteomyelitis patients with severe skin tissue defect and is worthy to be promoted in the hospital.

关 键 词：胫骨慢性骨髓炎 腓肠神经营养血管 万古霉素硫酸钙骨水泥 感染 

分 类 号：R681.2[医药卫生—骨科学]