Masquelet技术与Ilizarov技术治疗胫骨感染性骨不连效果  

Effects of Masquelet technique and Ilizarov technique on patients with infectious nonunion of tibia

作　　者：黄永湘 李强[2] 李宝林 陶永亮 张俊杰 HUANG Yong-xiang;LI Qiang;LI Bao-lin;TAO Yong-liang;ZHANG Jun-jie(Danzhou People's Hospital,Danzhou,Hainan 571700,China)

机构地区：[1]儋州市人民医院骨科,海南儋州571700 [2]海南医学院第二附属医院骨科,海南海口570216 [3]广东医科大学附属湛江肿瘤医院骨科,广东湛江524001

出　　处：《中华医院感染学杂志》2021年第10期1557-1561,共5页Chinese Journal of Nosocomiology

基　　金：儋州市科技计划基金资助项目(2017A213ZZ)。

摘　　要：目的比较Masquelet技术与Ilizarov技术对胫骨感染性骨不连患者感染清除率、骨愈合率和肢体功能的影响.方法回顾性收集2016年2月-2019年4月儋州市人民医院治疗的胫骨感染性骨不连87例患者的临床资料,根据治疗方法分为Masquelet组39例和Ilizarov组48例,比较两组患者临床疗效、炎症指标C-反应蛋白(CRP)和降钙素原(PCT)水平、相关治疗指标(骨愈合时间、完全负重时间、手术次数、治疗费用)、并发症及肢体功能.结果Masquelet组和Ilizarov组治疗优良率分别为74.36%和87.50%,两组比较无显著差异;术后1个月、术后3个月时,Ilizarov组CRP和PCT水平均低于Masquelet组(P<0.05),但末次随访时,两组CRP和PCT水平比较差异无统计学意义;Masquelet组骨愈合时间、完全负重时间及治疗费用均优于Ilizarov组(P<0.05),两组手术次数比较差异无统计学意义;Masquelet组"障碍"类并发症发生率低于Ilizarov组(P<0.05),两组"问题"和"真正并发症"类并发症发生率比较无显著差异;术前和末次随访时,两组肢体功能HSS评分和Baird评分比较差异无统计学意义.结论Masquelet技术与Ilizarov技术对胫骨感染性骨不连患者均有较好疗效,两种方法各有优缺点,临床需结合患者实际情况选择治疗方案.OBJECTIVE To explore the effects of Masquelet technique and Ilizarov technique on clearance rate of infection,bone healing rate and limb function of the patients with infectious nonunion of tibia.METHODS A total of 87 patients with infectious nonunion of tibia who were treated in the Danzhou People′s Hospital from Feb 2016 to Apr 2019 were retrospectively enrolled in the study and divided into the Masquelet group with 39 cases and the Ilizarov group with 48 cases according to the treatment method.The clinical curative effects,inflammatory factors C-reactive protein(CRP)and procalcitonin(PCT),related treatment indexes(bone healing time,full weight-bearing time,number of times of surgery,treatment cost),complications and limb function were observed and compared between the two groups of patients.RESULTS The rate of excellent and good treatment was 74.36%in the Masquelet group,87.50%in the Ilizarov group,and there was no significant difference between the two groups.The levels of CRP and PCT of the Ilizarov group were significantly lower than those of the Masquelet group(P<0.05),however,there were no significant differences in the levels of CRP and PCT between the two groups at the end of follow-up.The bone healing time and full weight-bearing time of the Masquelet group were significantly shorter than those of the Ilizarov group,and the treatment cost of the Masquelet group was less than that of the Ilizarov group(P<0.05).There was no significant difference in the number of time of surgery between the two groups.The incidence of′disorder′-related complications of the Masquelet group was significantly lower than that of the Ilizarov group(P<0.05);there were no significant differences in the incidence rates of′problem′-and′true complications′-related complications between the two groups.There were no significant differences in the limb function HSS score and Baird score between the two groups before the surgery and at the end of follow-up.CONCLUSION Both Masquelet technique and Ilizarov technique can ac

关 键 词：胫骨感染性骨不连 Masquelet技术 ILIZAROV技术 骨愈合 肢体功能 

分 类 号：R687.3[医药卫生—骨科学]