松质骨移植联合封闭植皮治疗创伤后骨髓炎的效果  

CLINICAL EFFECT OF CANCELLOUS BONE TRANSPLANTATION COMBINED WITH CLOSED SKIN GRAFTING FOR POST-TRAUMATIC OSTEOMYELITIS

作　　者：周世强 曹锐 程亚锋 ZHOU Shiqiang;CAO Rui;CHENG Yafeng(Department of Orthopedics, Chongqing Wanzhou District Hospital of Traditional Chinese Medicine, Chongqing 404000, Chin)

机构地区：[1]重庆市万州区中医院骨科,重庆404000

出　　处：《齐鲁医学杂志》2017年第5期573-576,共4页Medical Journal of Qilu

基　　金：重庆市万州区科技支撑计划项目(2015SZ4578)

摘　　要：目的探讨松质骨移植联合封闭植皮治疗创伤后骨髓炎的效果。方法选择2014年1月—2016年1月在我院接受治疗的创伤后骨髓炎病人40例,按照随机数字表法将病人分为观察组和对照组各20例。观察组行松质骨移植联合封闭植皮治疗,对照组行传统开放植骨手术治疗。比较两组病人的治疗效果。结果两组病人清创术前的软组织缺损面积差异无显著性(P>0.05);术后1、2个月,两组病人的软组织缺损面积均较术前显著缩小,且观察组明显小于对照组,两组比较差异有统计学意义(t=3.28、2.08,P<0.05)。观察组病人创面愈合无渗出时间、骨性愈合时间均短于对照组,差异有显著性(t=11.32、9.30,P<0.05)。观察组病人无复发,对照组病人有4例复发,两组比较差异有统计学意义(χ~2=4.44,P<0.05)。观察组病人的优良愈合率为95%,对照组为60%,两组比较差异有统计学意义(χ~2=7.03,P<0.05)。结论松质骨移植联合封闭植皮治疗创伤后骨髓炎,创面愈合时间短,骨性愈合迅速,感染、复发率低,高效、安全,值得临床推广应用。Objective To investigate the clinical effect of cancellous bone transplantation combined with closed skin grafting in the treatment of posttraumatic osteomyelitis.Methods Totally 40 cases of post-traumatic osteomyelitis in our hospital from January 2014 to January 2016 were randomly divided into treatment group（n=20）and control group（n=20）with a random number table.The patients in the treatment group were treated by cancellous bone transplantation combined with closed skin grafting,and the control group by traditional open bone grafting surgery.The clinical outcome was compared between the two groups.Results Before debridement,the area of soft tissue defect showed no significant difference between the two groups（P〈0.05）.At postoperative 1 and 2 months,the area of soft tissue defect was significantly decreased in both groups,and it was significantly smaller in the treatment group than in the control group（t=3.28 and 2.08,P〈0.05）.The wound healing time and bone healing time in the treatment group were significantly shorter than those in the control group（t=11.32 and 9.30,P〈0.05）.No recurrence was observed in the treatment group,while 4 patients had recurrence in the control group,indicating a significant difference（χ2=4.44,P〈0.05）.The percentage of patients with excellent healing was 95%in the treatment group and 60%in the control group,suggesting a significant difference（χ2=7.03,P〈0.05）.Conclusion Cancellous bone transplantation combined with closed skin grafting for traumatic osteomyelitis has the advantages of short wound healing time,quick bone healing,low infection rate,low recurrence rate,and high efficiency and safety,and it holds promise for clinical application.

关 键 词：骨髓炎 骨移植 皮肤移植 治疗结果 

分 类 号：R681.2[医药卫生—骨科学]