Ilizarov外固定技术联合负压封闭引流、抗生素治疗胫骨感染性骨不连效果观察  

Effect of Ilizarov external fixation combined with negative pressure sealing drainage and antibiotics in the treatment of infective tibial nonunion

作　　者：李光[1] 魏有强 郭启发[1] 张海云 洛松久美 卢仲琳[1] 李长帅 LI Guang;WEI You-qiang;GUO Qi-fa;ZHANG Hai-yun;LUO-SON Jiu-mei;LU Zhong-lin;LI Chang-shuai(Department of Trauma and Bone Surgery,Affiliated Hospital of Qinghai University,Xining 810000,China;Department of Orthopaedics,the First People's Hospital of Suizhong County,Qinghai Province,Suizhong 811600,China;Department of Orthopaedics,Red Cross Hospital,Datong County,Qinghai Province,Datong County 810100,China;Department of Orthopaedics,Bayi Hospital,Yushu Prefecture,Qinghai Province,Yushu 815000,China)

机构地区：[1]青海大学附属医院创伤骨病外科,青海西宁810000 [2]青海省湟中县第一人民医院骨科,青海湟中811600 [3]青海省大通县红十字医院骨科,青海大通810100 [4]青海省玉树州八一医院骨科,青海玉树815000

出　　处：《海南医学院学报》2019年第22期1718-1722,共5页Journal of Hainan Medical University

基　　金：青海省卫计委适宜技术推广项目(2018-wjtg-03)~~

摘　　要：目的:Ilizarov外固定技术联合负压封闭引流、抗生素治疗胫骨感染性骨不连效果观察。方法:选择在本院收治的79例胫骨感染性骨不连患者,随机分为两组,对照组39例行Ilizarov外固定技术,研究组40例在对照组基础上联合负压封闭引流、抗生素。记录骨骼愈合时间与日常步行情况,并对不同时间Rasmussen评分、血清细胞间黏附分子-1(ICAM-1)与IL-6水平、下肢Fugl-Meyer运动功能评分与下肢BI指数评分进行比较。结果:研究组日常步行情况明显优于对照组(P<0.05),骨骼愈合时间明显少于对照组(P<0.05);研究组治疗后1、6、12个月Rasmussen评定分值均大于对照组(P<0.05);治疗后2组血清ICAM-1与IL-6水平均低于治疗前(P<0.05),且研究组治疗后血清ICAM-1与IL-6水平均低于对照组(P<0.05);治疗后两组下肢Fugl-Meyer运动功能评分与下肢BI指数评分均大于治疗前(P<0.05),且研究组治疗后下肢Fugl-Meyer运动功能评分与下肢BI指数评分均大于对照组(P<0.05)。结论:Ilizarov外固定技术联合负压封闭引流、抗生素,可促进胫骨感染性骨不连患者骨骼愈合,明显改善其日常步行情况,炎症得到缓解,膝关节功能与下肢功能恢复良好。Objective:To observe the effect of Ilizarov external fixation combined with negative pressure sealing drainage and antibiotics in the treatment of infective tibial nonunion.Methods:A total of 79 patients with tibial infective nonunion who were treated in our hospital from August 2016 to August 2018 were divided into two groups according to random number table,39 patients in the control group were treated with Ilizarov external fixation technology,and 40 patients in the study group were treated with negative pressure sealing drainage and antibiotics on the basis of the control group.Bone healing time and daily walking were recorded,Rasmussen score,serum intercellular adhesion molecule-1(ICAM-1)and IL-6 levels,lower limb Fugl-Meyer motor function score and lower limb BI index score were compared at different time.Results:The daily walking condition of the study group was significantly better than that of the control group(P<0.05),and the healing time of bone was significantly shorter than that of the control group(P<0.05);the Rasmussen score of the study group was higher than that of the control group at 1 month,6 months and 12 months after treatment(P<0.05);the levels of serum ICAM-1 and IL-6 in the two groups after treatment were lower than those before treatment(P<0.05),and the levels of serum ICAM-1 and IL-6 in the study group were lower than those in the control group after treatment(P<0.05);the lower limb Fugl-Meyer motor function score and lower limb BI index score of the two groups after treatment were higher than those before treatment(P<0.05),and the lower limb Fugl-Meyer motor function score and lower limb BI index score of the study group after treatment were higher than those of the control group(P<0.05).Conclusions:Ilizarov external fixation combined with negative pressure sealing drainage and antibiotics can promote the bone healing of patients with tibial infective nonunion,significantly improve their daily walking condition,alleviate inflammation,and recover knee joint function and lower limb funct

关 键 词：Ilizarov外固定技术 负压封闭引流 抗生素 胫骨感染性骨不连 骨骼愈合时间 血清细胞间黏附分子-1水平 

分 类 号：R687.3[医药卫生—骨科学]