万古霉素骨水泥在开放性跟骨骨折患者术后感染中的应用  

Application of Vancomycin bone cement in the postoperative infection in patients with open calcaneal fractures

作　　者：陈仲亮 卢建新[1] 李达 崔军[1] CHEN Zhongliang;LU Jianxin;LI Da;CUI Jun(Department of Foot Ankle Surgery,Central Hospital Affiliated To Shenyang Medical College,Liaoning Province,Shenyang110024,China)

机构地区：[1]沈阳医学院附属中心医院足踝外科,辽宁沈阳110024

出　　处：《中国当代医药》2022年第2期65-68,共4页China Modern Medicine

基　　金：沈阳医学院科技基金项目(20162027)。

摘　　要：目的探讨万古霉素骨水泥在开放性跟骨骨折患者术后感染治疗中的临床效果。方法选取2016年1月至2020年12月沈阳医学院附属中心医院骨科和手足外科收治的46例开放性跟骨骨折术后感染患者作为研究对象,采用随机数字表法将其分为对照组与观察组,每组各23例。对照组患者采用常规治疗,彻底清创、清除坏死组织和抗生素持续灌注冲洗。观察组患者在对照组的基础上根据药敏试验结果选择万古霉素骨水泥填塞骨缺损位置。比较两组患者的治疗总有效率、换药次数、创面愈合时间、感染控制时间、住院时间、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平、中性粒细胞、白细胞计数以及红细胞沉降率。结果观察组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者的换药次数少于对照组,差异有统计学意义(P<0.01)。观察组患者的创面愈合时间、感染控制时间以及住院时间均短于对照组,差异有统计学意义(P<0.01)。治疗后,观察组患者的TNF-α、IL-6、中性粒细胞、白细胞计数、CRP以及红细胞沉降率均低于对照组,差异有统计学意义(P<0.01)。结论万古霉素骨水泥对开放性跟骨骨折术后感染具有良好的控制感染和抑制炎症反应作用,治疗效果较好。Objective To explore the efficacy of Vancomycin bone cement in the treatment of postoperative infections in patients with open calcaneal fractures.Methods A total of 46 patients with open calcaneal fractures who were admitted to the Department of Orthopedics and Chiropodist of the Affiliated Central Hospital of Shenyang Medical College from January 2016 to December 2020 were selected as the research objects.They were divided into the control group and the observation group by random number table method,with 23 cases in each group.The control group received routine treatment,complete debridement,removal of necrotic tissue and continuous irrigation with antibiotics.On the basis of the control group,Vancomycin bone cement was selected to fill the bone defect in the observation group according to the drug sensitivity test results.The total effective rate,times of dressing change,wound healing time,infection control time,length of hospital stay,serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),neutrophils,white blood cell count and erythrocyte sedimentation rate were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The frequency of dressing change in the observation group was less than that in the control group,and the difference was statistically significant(P<0.01).The wound healing time,infection control time and hospital stay time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.01).After treatment,TNF-α,IL-6,neutrophil,white blood cell count,CRP and erythrocyte sedimentation rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.01).Conclusion Vancomycin bone cement has a good effect on controlling infection and inhibiting inflammation in patients with postoperative infection of open ca

关 键 词：开放性跟骨骨折 术后感染 万古霉素 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]