保留及去除内固定物治疗骨折内固定术后感染疗效比较  

Comparison of Efficacy of Retention and Removal of Internal Fixation in Treatment of Infection after Fracture Internal Fixation

作　　者：李铁军[1] 康锦 郑铁钢[1] 文华军 薛杨[1] 李永乐[1] 刘爱文 吕志勇 鲁志平 LI Tie-jun;KANG Jin;ZHENG Tie-gang;WEN Hua-jun;XUE Yang;LI Yong-le;LIU Ai-wen;LV Zhi-yong;LU Zhi-ping(Department of Orthopedics,The 251 st Hospital of PLA,Zhangjiakou,Hebei 075000,China;Department of Orthopedics,Shangdu County Hospital,Shangdu,Inner Mongolia 013450,China)

机构地区：[1]中国人民解放军陆军第八十一集团军医院骨科,河北张家口075000 [2]内蒙古自治区商都县医院骨科,内蒙古商都013450

出　　处：《河北北方学院学报（自然科学版）》2022年第8期6-10,共5页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市重点研发计划项目(No.1921113D)。

摘　　要：目的探讨保留及去除内固定物治疗骨折内固定术后感染的临床疗效。方法回顾性分析31例骨折内固定术后感染患者,其中采取去除内固定物(A组)的方法治疗18例,采取在“低毒力感染”状态下保留内固定物(B组)的方法治疗13例。比较2组患者术后骨折愈合时间、并发症及住院总费用,采用Samantha X线评分标准评价骨愈合质量,采用Paley方法评价邻近关节功能。结果31例患者均获随访,平均19.5个月(13~41个月)。A组平均愈合时间6.8个月,B组13个月。Samantha X线评分A组平均5.1分,B组4.6分。Paley关节功能评价A组优5例,良3例,可7例,差3例,优良率为44%;B组优7例,良4例,可2例,优良率为85%。住院总费用A组108534.47~174591.74元,平均151563.1元;B组18507.94~38140.19元,平均25324.07元。结论在“低毒力感染”状态下保留内固定物治疗骨折内固定术后感染有利于骨折部位邻近关节功能的锻炼,极大降低医疗费用,临床疗效满意。Objective To explore the clinical efficacy of retention and removal of internal fixation in treatment of Infection after internal fixation.Methods A retrospective study was made on 31 cases with infection after internal fixation,in which 18 were treated with the method of removing internal fixation(group A),and 13 were treated with the method of retaining internal fixation under"low virulence infection"(group B).The fracture healing time,complications and total hospitalization cost were compared between the two groups.The Samantha X-ray scoring standard was used to evaluate the quality of bone healing,and the Paley method was used to evaluate function of adjacent joints.Results All 31 patients were followed up for 13 to 41 months with an average of 19.5 months.The average healing time of group A was 6.8 months,while group B 13 months;Samantha X-ray score was 5.1 points in group A and 4.6 points in group B.Paley joint function evaluation shown that group A was excellent in 5 cases,good in 3 cases,fair in 7 cases and poor in 3 cases,with excellent and good rate 44%and group B was excellent in 7 cases,good in 4 cases,fair in 2 cases with excellent and good rate 85%.The total hospitalization expenses of group A were 108,534.47￥to 174,591.74￥,with an average of 151,563.1￥,and that of group B was 18,507.94￥to 38,140.19￥,with an average of 25,324.07￥.Conclusions In the"low virulence infection"state,retaining internal fixation to treat the infection after fracture internal fixation is beneficial to the exercise of the adjacent joint function of the fracture site,greatly reducing the medical expense and obtaining satisfactory clinical effect.

关 键 词：骨折固定术 内 感染 内固定物 愈合 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R687.3[医药卫生—内科学]