抗生素骨水泥联合个体化设计组织瓣在创伤性骨髓炎治疗中的临床应用  

Clinical Application of Antibiotic Bone Cement Combined with Tissue Flap of Individualized Design in Treatment of Traumatic Osteomyelitis

作　　者：文华军 文茂君 李铁军[1] 张朋[1] 薛杨[1] 李永乐[1] 郑铁钢[1] 吕志勇 鲁志平 WEN Hua-jun;WEN Mao-jun;LI Tie-jun;ZHANG Peng;XUE Yang;LI Yong-le;ZHENG Tie-gang;LV Zhi-yong;LU Zhi-ping(Department of Orthopedics,The 81^(st) Group Army 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10期5-9,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：目的探讨抗生素骨水泥联合个体化设计组织瓣治疗创伤性骨髓炎的临床疗效。方法回顾性分析18例应用抗生素骨水泥联合个体化设计组织瓣治疗的创伤性骨髓炎患者的临床资料。患者均彻底清创清除感染灶,大流量冲洗,抗生素骨水泥链珠填充软组织死腔,抗生素骨水泥柱填充骨缺损,配合全身使用敏感抗生素彻底控制感染,然后个体化设计组织瓣覆盖创面,术后6~8周行骨折内固定并在诱导膜腔内植骨以修复骨缺损。结果18例患者术后均获14~26个月随访。所有患者皮瓣均Ⅰ期成活,完全骨愈合时间18~41周,术后均无感染复发,无严重并发症发生。末次随访时采用Johner-Wruhs评分标准评定疗效:优9例,良7例,中2例,总体优良率88.9%。结论抗生素骨水泥联合个体化设计组织瓣治疗创伤性骨髓炎疗效较好,值得临床推广应用。Objective To study the clinical effect of antibiotic bone cement combined with tissue flap of individualized design in the treatment of traumatic osteomyelitis.Methods The clinical data of 18 patients with traumatic osteomyelitis treated with antibiotic bone cement combined with tissue flap of individualized design were analyzed retrospectively.Thorough debridement to clear the infected foci,large flow flushing,antibiotic-PMMA beads filling the soft tissue dead space,and antibiotic bone cement mass filling the bone defect,combined with intravenous antibiotics,were accomplished to control the infection completely.Then the soft tissue defect was covered with tissue flap of individualized design.Six to eight weeks later,internal fixation and bone defect treated by transplanting autologous iliac bone were performed.Results All 18 cases were followed up for 14-26 months.All the tissue flaps survived.All patients observed the complete bone healing in 18-41 weeks,without recurrent infection and serious complications.The functional recovery of 18 cases in this group was evaluated according to the Johner-Wruhs evaluation standard.The results were excellent in 9 cases,good in 7 cases,fair in 2 cases,and the total effective rate reached 88.9%.Conclusion Antibiotic bone cement combined with tissue flap of individualized design in the treatment of traumatic osteomyelitis is a method worthy of clinical promotion.

关 键 词：抗生素骨水泥 组织瓣 骨髓炎 骨缺损 

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]