双平面截骨骨搬运联合载抗生素硫酸钙治疗下肢大段感染性骨缺损的疗效观察  

Biplane osteotomy combined with antibiotic loaded calcium sulfate in the treatment of large infectious bone defects of lower limbs

作　　者：戚鸿飞 任程[1] 马腾[1] 李明[1] 许毅博 杨彦玲[2] 张堃[1] 李忠[1] QI Hong-fei;REN Cheng;MA Teng;LI Ming;XU Yi-bo;YANG Yan-ling;ZHANG Kun;LI Zhong(Lower Limb Ward,Trauma Hospital of Xi’an Honghui Hospital Affiliated to Xi’an Jiaotong University,Xi’an,Shaanxi,710054,China)

机构地区：[1]西安交通大学附属西安市红会医院创伤病院下肢病区,陕西710054 [2]延安大学医学院,陕西716000

出　　处：《中国骨与关节杂志》2023年第3期216-220,共5页Chinese Journal of Bone and Joint

基　　金：陕西省科技厅科研基金(2021SF-243)。

摘　　要：目的观察双平面截骨骨搬运联合载抗生素硫酸钙治疗下肢大段感染性骨缺损的临床疗效。方法回顾性分析2019年2月至2020年11月西安交通大学附属红会医院收治的12例下肢大段感染性骨缺损患者的病历资料,主要治疗方法采用双平面截骨骨搬运联合载抗生素硫酸钙,记录所有患者的骨缺损长度、伤口分泌物细菌培养结果、硫酸钙吸收时间、骨搬运时间、外固定带架时间以及术后并发症情况。采用Paley评分进行评价骨缺损的愈合情况及关节功能。结果纳入的12例患者无1例感染复发,骨再生区均固化良好。其中硫酸钙的吸收时间平均为(7.08±1.98)个月、骨搬运时间为(10.25±2.42)周、外固定带架时间(10.58±2.54)个月。最后一次随访时Paley骨愈合和关节功能评分结果显示,9例患者为优,3例患者为良。结论双平面截骨骨搬运联合载抗生素硫酸钙是治疗下肢大段感染性骨缺损的一种有效治疗方法,它可以缩短骨搬运的治疗周期,避免感染复发。Objective To observe the clinical effect of biplane osteotomy combined with antibiotic loaded calcium sulfate in the treatment of large infectious bone defects of lower limbs.Methods The medical records of 12 patients with large infectious bone defects of lower limbs,treated in the Red Cross Hospital Affiliated to Xi’an Jiaotong University from February 2019 to November 2020,were analyzed retrospectively.The main treatment methods included biplane osteotomy and bone handling combined with antibiotic loaded calcium sulfate.The length of bone defect,bacterial culture results of wound secretion,calcium sulfate absorption time,bone transport time,external fixation belt time and postoperative complications were recorded.The bone defect healing and joint function were evaluated by Paley score.Results There was no recurrence of infection in the 12 patients included in the study,and the regeneration area solidified well.The average absorption time of calcium sulfate was(7.08±1.98)months,the bone transport time was(10.25±2.42)weeks,and the external fixation frame time was(10.58±2.54)months.At the last follow-up,according to Paley’s bone healing and joint function score,9 patients were excellent and 3 patients were good.Conclusions Biplane osteotomy combined with antibiotic loaded calcium sulfate is an effective method for the treatment of large infectious bone defects of lower limbs.It can shorten the treatment cycle of bone transportation and avoid the recurrence of infection.

关 键 词：感染 硫酸钙 骨延长术 

分 类 号：R681.8[医药卫生—骨科学]