万古霉素骨水泥治疗感染性骨缺损早期临床效果观察  

Early clinical effect of vancomycin cement in the treatment of infected bone defects

作　　者：张鑫[1] 钱贵宾[1] 姜明久[1] 张博睿 胡一凡 杨大威[1] ZHANG Xin;QIAN Gui-bin;JIANG Ming-jiu;ZHANG Bo-rui;HU Yi-fan;YANG Da-wei(Department of Orthopedics,Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院骨科,黑龙江哈尔滨150001

出　　处：《临床军医杂志》2023年第1期12-14,18,共4页Clinical Journal of Medical Officers

基　　金：哈尔滨医科大学附属第四医院特别资助科研项目(HYDSYTB202126)。

摘　　要：目的 探讨万古霉素骨水泥治疗感染性骨缺损的早期临床效果。方法 选取哈尔滨医科大学附属第四医院自2019年8月至2021年8月收治的30例感染性骨缺损患者为研究对象。根据不同的手术方式将患者分为A组与B组,每组各15例。A组患者接受常规治疗。B组患者在A组基础上,采用万古霉素骨水泥进行治疗。记录并比较两组患者的术后血清炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]、骨折愈合情况[视觉模拟评分法(VAS)评分、骨折愈合时间]与感染控制情况。结果 B组患者术后血清WBC、CRP、ESR、TNF-α、IL-6水平均显著低于A组,差异均有统计学意义(P<0.05)。B组患者VAS评分与骨愈合时间均低于A组,差异均有统计学意义(P<0.05)。B组患者平均清创次数显著低于A组,差异有统计学意义(P<0.05)。B组的再次手术比例低于A组,感染控制比例高于A组。结论 万古霉素骨水泥治疗感染性骨缺损可有效降低患者术后平均清创次数、血清炎症指标、再手术率及感染控制率,骨折愈合情况更优,术后早期疗效显著。Objective To investigate the early clinical effect of vancomycin cement in the treatment of infected bone defects.Methods Thirty patients with infectious bone defects admitted to the Fourth Affiliated Hospital of Harbin Medical University from August 2019 to August 2021 were selected as the research objects.The patients were divided into group A and group B according to different surgical methods, 15 cases in each group.Patients in group A received conventional treatment.Patients in group B were treated with vancomycin bone cement on the basis of group A.Record and compare the two groups of patients with postoperative serum inflammation index [white blood cell(WBC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)],fracture healing of [visual analogue scale(VAS),fracture healing time]and infection control.Results The serum levels of WBC,CRP,ESR,TNF-α and IL-6 in group B were significantly lower than those in group A,and the differences were statistically significant(P<0.05).The VAS and bone healing time of group B were lower than those of group A,and the differences were statistically significant(P<0.05).The average number of debridement in group B was significantly lower than that in group A,and the difference was statistically significant(P<0.05).The proportion of reoperation in group B was lower than that in group A,and the proportion of infection control was higher than that in group A.Conclusion Vancomycin cement can effectively reduce the average number of debridement, serum inflammation index, reoperation rate and infection control rate, and the fracture healing is better, and the early postoperative effect is significant.

关 键 词：感染性骨缺损 万古霉素骨水泥 聚甲基丙烯酸甲酯 早期临床效果 

分 类 号：R681.2[医药卫生—骨科学]