改良载抗生素骨水泥在胸骨感染性骨缺损中的应用研究  

Application of Modified Antibiotic Loaded Bone Cement in Sternal Infected Bone Defect

作　　者：袁键冰 谢晓勇 周健和 YUAN Jianbing;XIE Xiaoyong;ZHOU Jianhe(Department of Traumatic Orthopedics,Dongguan Kanghua Hospital,Dongguan Guangdong 523000,China;Department of Burn and Plastic Surgery,Dongguan Kanghua Hospital,Dongguan Guangdong 523000,China)

机构地区：[1]东莞康华医院创伤骨科,广东东莞523000 [2]东莞康华医院烧伤整形科,广东东莞523000

出　　处：《中国卫生标准管理》2023年第11期98-102,共5页China Health Standard Management

基　　金：东莞市社会科技发展(一般)项目(202050715059761)。

摘　　要：目的探讨改良载抗生素骨水泥与传统的骨水泥诱导膜手术方法在心脏手术后胸骨感染性骨缺损中的临床应用。方法选取2019年9月—2022年10月东莞康华医院烧伤科收治的30例直视下心脏手术后出现胸骨感染性骨缺损患者。15例作为试验组,采用改良载抗生素骨水泥[自固化磷酸钙(calcium phosphate cement,CPC)+敏感抗生素+联合骨形态发生蛋白(bone morphogenetic protein,BMP)];15例作为对照组,采用传统骨水泥诱导膜手术方法。比较两组一期手术切口愈合时间、二期手术切口愈合时间、住院时间、术后并发症如浅部感染、深部感染、出血等。结果试验组住院时间为(53.87±3.74)d,对照组住院时间为(63.13±7.74)d,试验组住院时间短于对照组(P<0.001)。但在一期手术切口愈合时间、二期手术切口愈合时间、浅感染、深感染、出血等方面差异无统计学意义(P>0.05)。结论对于直视下心脏手术后胸骨感染性骨缺损的患者选择载抗生素骨水泥技术,相对于传统的骨水泥诱导膜方法能有效缩短住院时间,没有增加手术切口愈合时间,也没有增加感染以及出血的风险。Objective To explore the clinical application of the modified antibiotic loaded bone cement and the traditional bone cement-induced membrane surgery in patients with infected sternal bone defects after cardiac surgery.Methods A total of 30 patients with sternal infectious bone defect after direct heart surgery admitted to the department of burn of Dongguan Kanghua Hospital from September 2019 to October 2022 were selected.15 patients as experimental group were treated with improved antibiotic loaded bone cement[calcium phosphate cement(CPC)+sensitive antibiotics+combined bone morphogenetic protein(BMP)].15 patients as control group were treated with traditional bone cementinduced membrane surgery.First-stage incision healing time,second-stage incision healing time,length of hospital stay,postoperative complications such as superficial infection,deep infection and bleeding were compared between the two groups.Results The duration of hospitalization in the experimental group was(53.87±3.74)d,and that in the control group was(63.13±7.74)d.The duration of hospitalization in the experimental group was shorter than that in the control group(P<0.001).But there was no significant difference in first-stage incision healing time,second-stage incision healing time,superficial infection,deep infection and bleeding(P>0.05).Conclusion For patients with infected sternal bone defects after open heart surgery,antibiotic loaded bone cement technology can effectively shorten the length of hospital stay,without increasing the healing time of surgical incision,and without increasing the risk of infection and bleeding compared with traditional bone cement-induced membrane method.

关 键 词：胸骨感染 骨缺损 心脏手术后 载抗生素骨水泥 住院时间 骨水泥诱导膜 

分 类 号：R639[医药卫生—外科学]