万古霉素人工骨联合外固定支架治疗慢性胫骨骨髓炎的疗效及其对膝关节功能、踝关节功能和炎性因子的影响  

Effect of vancomycin artificial bone combined with external fixation frame on chronic tibial osteomyelitis and its effects on knee joint function,ankle joint function and inflammatory factors

作　　者：唐旭[1] 陈帅[1] 田鹏[1] 庄万强 TANG Xu;CHEN Shuai;TIAN Peng(Department of Orthopaedics,Jianyang People's Hospital,Jianyang Sichuan 641400,China)

机构地区：[1]四川省简阳市人民医院骨科

出　　处：《临床和实验医学杂志》2019年第15期1650-1653,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫计委科研课题(No.20160112)

摘　　要：目的观察万古霉素人工骨联合外固定支架治疗慢性胫骨骨髓炎的疗效及其对膝关节功能、踝关节功能和炎性因子的影响。方法随机选择2015年1月至2017年12月简阳市人民医院进行慢性胫骨骨髓炎治疗的患者60例进行前瞻性研究。采用随机数字法将患者分为观察组和对照组各30例。对照组患者给予常规人工骨植入联合外固定支架治疗;观察组患者给予万古霉素人工骨联合外固定支架治疗。比较两组患者临床疗效,治疗前后膝关节功能、踝关节功能以及生活质量评分、炎性因子[白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、干扰素诱生蛋白10(IP-10)]水平以及膝关节与踝关节活动度情况。结果随访1个月,观察组治疗总有效率为93.33%,明显高于对照组的73.33%。两组患者治疗前HSS评分、AOFAS评分、SF-36评分、膝关节活动度、踝关节活动度无显著差异(P>0.05)。治疗后1个月,两组患者各项评分和膝关节与踝关节活动度均明显升高,且观察组明显高于对照组,差异有显著性(P<0.05)。两组患者治疗前IL-6、IL-17、IP-10无显著差异(P>0.05);治疗后1个月,两组患者IL-6、IL-17、IP-10水平均明显降低,但观察组IL-6、IL-17、IP-10水平明显低于对照组,差异有统计学意义(P<0.05)。结论万古霉素人工骨联合外固定支架能够明显提高慢性胫骨骨髓炎的临床疗效,改善患者膝关节和踝关节功能和活动度,降低炎性因子水平,具有较高的临床应用价值。Objective To observe the effect of vancomycin artificial bone combined with external fixator on chronic tibial osteomyelitis and its influence on knee joint function,ankle joint function and inflammatory factors.Methods 60 patients with chronic tibial osteomyelitis treated in our hospital from January 2015 to December 2017 were randomly selected for clinical study.The patients were divided into observation group and control group by random number method.The patients in control group were treated with conventional artificial bone implantation combined with external fixator.The patients in the observation group were treated with vancomycin artificial bone combined with external fixator.The clinical efficacy,knee function,ankle function,quality of life,inflammatory factors and knee and ankle motion were compared between the two groups before and after treatment.Results After one month follow-up,the total effective rate of the observation group was 93.33%,which was significantly higher than that of the control group(73.33%).There was no significant difference in HSS score,AOFAS score,SF-36 score,knee joint activity and ankle joint activity between the two groups before treatment(P>0.05).After one month of treatment,the scores and activity of the two groups were significantly increased,but the observation group was significantly higher than that of the control group,with significantly statistical difference(P<0.05).There was no significant difference in IL-6,IL-17 and IP-10 between the two groups before treatment(P>0.05).One month after treatment,the levels of inflammatory factors in the two groups were significantly decreased,but the levels of inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Vancomycin artificial bone combined with external fixator can significantly improve the clinical efficacy of chronic tibial osteomyelitis,improve the function and mobility of knee and ankle joints,and reduce the level of inflammatory factors.It has high clin

关 键 词：慢性胫骨骨髓炎 万古霉素 人工骨外固定支架 膝关节功能 踝关节功能 炎性因子 

分 类 号：R687.3[医药卫生—骨科学]