病灶清除载抗生素硫酸钙置入治疗硬化性骨髓炎  

Debridement and antibiotic-loaded calcium sulfate for treatment of sclerosing osteomyelitis

作　　者：化昊天 王新卫 张磊 郭再冉 陈江非 HUA Hao-tian;WANG Xin-wei;ZHANG Lei;GUO Zai-ran;CHEN Jiang-fei(Luoyang Orthopedic Hospital of Henan Province,Luoyang 471002,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院),河南洛阳471002

出　　处：《中国矫形外科杂志》2022年第12期1122-1125,共4页Orthopedic Journal of China

基　　金：河南省科技攻关项目(编号:182102310487)。

摘　　要：[目的]探讨病灶清除联合抗生素人工骨治疗硬化性骨髓炎的临床疗效。[方法]回顾性分析本科2016年2月—2020年11月收治的28例硬化性骨髓炎患者的临床资料,所有患者均行病灶清除抗生素人工骨植入术。观察临床及实验室检查结果。[结果]28例患者均顺利完成手术,无严重并发症。术后1周患肢肿痛逐渐消失、伤口愈合。平均随访时间(30.18±18.43)个月,末次随访时VAS评分较术前显著降低(P<0.05)。所有患者均未出现病理性骨折,2例术后复发,再次病灶清除载抗生素硫酸钙置入后治愈。影像方面,末次随访时病灶愈合骨改建,人工骨已完全吸收。与术前相比,末次随访时CRP、ESR和WBC均显著降低(P<0.05)。[结论]病灶清除联合抗生素人工骨植入治疗硬化性骨髓炎可以有效控制感染、缓解疼痛,值得临床推广。[Objective]To investigate the clinical efficacy of debridement combined with antibiotic-loaded calcium sulfate implantation in the treatment of sclerosing osteomyelitis.[Methods]A retrospective study was conducted on 28 patients who received surgical debridement combined with antibiotic-loaded calcium sulfate implantation for sclerosing osteomyelitis in our department from February 2016to November 2020.The clinical and laboratory results were observed.[Results]All 28 patients were successfully operated on without serious complications.One week after surgery,the swelling and pain disappeared gradually with well incision healing in all the patients.The VAS score significantly decreased at the latest follow-up lasted for(30.18±18.43)months on an average compared with that preoperatively(P<0.05).None of the patients had pathological fracture,whereas 2 patients had local recurrence after surgery,which were cured after revised debridement and antibiotic-loaded calcium sulfate implantation.Radiographically,the lesion healed with bone remodeling and complete absorption of the implant at the last follow-up.The CRP,ESR and WBC significantly declined at the latest follow-up compared with those preoperatively(P<0.05).[Conclusion]Debridement combined with antibiotic-loaded calcium sulfate implantation does effectively control infection and relieve pain for sclerosing osteomyelitis.

关 键 词：硬化性骨髓炎 病灶清除 载抗生素硫酸钙 疼痛 

分 类 号：R687[医药卫生—骨科学]