抗生素骨水泥在糖尿病足溃疡创面应用的临床效果  

Clinical effects of application of antibiotic bone cement in wounds of diabetic foot ulcers

作　　者：黄红军[1] 牛希华[1] 杨冠龙 王丽英[1] 石凡超 徐绍君 徐林刚[1] 李永林[1] Huang Hongjun;Niu Xihua;Yang Guanlong;Wang Liying;Shi Fanchao;Xu Shaojun;Xu Lingang;Li Yonglin(Department of Wound Repair,Zhengzhou First People's Hospital,Zhengzhou 450004,China)

机构地区：[1]郑州市第一人民医院创面修复科,450004

出　　处：《中华烧伤杂志》2019年第6期464-466,共3页Chinese Journal of Burns

摘　　要：目的探讨采用抗生素骨水泥治疗糖尿病足溃疡的临床效果。方法根据采用的治疗方式,将笔者单位2016年1月—2017年1月、2017年2月—2018年2月收治的符合入选标准的各18例糖尿病足溃疡患者分别纳入传统组(男11例、女7例,年龄53~79岁)、骨水泥组(男11例、女7例,年龄55~80岁)。传统组患者行常规清创+负压封闭引流,骨水泥组患者行常规清创+抗生素骨水泥覆盖。回顾性统计2组患者入院时及术后3、6、9、15d创面分泌物细菌培养阳性患者数,住院时间,手术次数,创面完全愈合时间。对数据行Fisher确切概率法检验、独立样本t检验。结果与传统组[(29±10)d、(4.6±1.2)次]比较,骨水泥组患者住院时间[(9±3)d]明显缩短、手术次数[(1.3±0.6)次]明显减少、术后各时间点创面分泌物细菌培养阳性患者数明显减少(t=8.177、9.896,P<0.05或P<0.01);2组患者入院时创面分泌物细菌培养阳性患者数和创面完全愈合时间比较,差异无统计学意义(t=0.175,P>0.05)。结论抗生素骨水泥治疗糖尿病足溃疡可减少术后创面分泌物细菌培养阳性患者数和手术次数,缩短患者住院时间。Objective To explore the clinical effects of antibiotic bone cement in the treatment of diabetic foot ulcers.Methods According to the treatment methods,18 patients with diabetic foot ulcers(11 males and 7 females,aged 53-79 years),who were conformed to the study criteria and admitted to our hospital from January 2016 to January 2017,were enrolled in traditional group;18 patients with diabetic foot ulcers(11 males and 7 females,aged 55-80 years),who were conformed to the study criteria and admitted to our hospital from February 2017 to February 2018,were enrolled in bone cement group.Wounds of patients in traditional group were treated with vacuum sealing drainage after conventional debridement.Wounds of patients in bone cement group were covered with antibiotic bone cement after conventional debridement.The number of patients with positive bacterial culture in wound exudate in the 2 groups on admission and 3,6,9,and 15 days after surgery,the length of hospital stay,the number of operation,and the wound complete healing time were retrospectively recorded.Data were processed with Fisher′s exact probability test and independent sample t test.Results Compared with(29±10)d and(4.6±1.2)times of patients in traditional group,the length of hospital stay[(9±3)d]of patients was obviously shortened,the number of operation[(1.3±0.6)times]of patients was obviously reduced,the number of patients with positive bacterial culture in wound exudate at each time point post surgery was obviously reduced(t=8.177,9.896,P<0.05 or P<0.01)in bone cement group.There were no statistically significant differences in the number of patients with positive bacterial culture in wound exudate on admission and wound complete healing time between patients in the 2 groups(t=0.175,P>0.05).Conclusions The antibiotic bone cement treatment of diabetic foot ulcers can reduce the number of patients with positive bacterial culture in wound exudate and the number of operation,as well as shorten the length of hospital stay.

关 键 词：糖尿病足 溃疡 创面 抗生素骨水泥 

分 类 号：R587.2[医药卫生—内分泌] R632.1[医药卫生—内科学]