负压封闭引流技术灌洗引流联合万古霉素骨水泥链珠植入治疗慢性骨髓炎的临床疗效研究  

Study on clinical efficacy of vacuum sealing drainage combined with vancomycin-impregnated bone cement beads in the treatment of chronic osteomyelitis

作　　者：胡仲辉 HU Zhong-hui(Xinzhou District Traditional Chinese Medicine Orthopedic Hospital,Wuhan 430410,China)

机构地区：[1]武汉市新洲区中医骨伤专科医院,430410

出　　处：《中国实用医药》2024年第13期125-127,共3页China Practical Medicine

摘　　要：目的 证实负压封闭引流技术灌洗引流联合万古霉素骨水泥链珠植入治疗慢性骨髓炎的临床疗效,为慢性骨髓炎的治疗提供新的治疗方案。方法 88例慢性骨髓炎患者,依据临床治疗方式不同分为对照组(常规引流联合抗生素灌洗治疗)和观察组(负压封闭引流技术灌洗引流联合万古霉素骨水泥链珠治疗),每组44例。对比两组围术期指标(应用抗生素时间、愈合时间、住院时间)、视觉模拟评分法(VAS)评分及血清学指标[血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平。结果 观察组应用抗生素时间(18.01±2.52)d、愈合时间(29.84±3.76)d、住院时间(31.22±4.11)d均短于对照组的(28.96±3.91)、(42.22±5.37)、(40.84±4.20)d,差异有统计学意义(P<0.05)。观察组治疗1个月后和治疗2个月后的VAS评分分别为(2.42±1.03)、(1.74±0.87)分,均低于对照组的(3.14±1.25)、(2.25±0.98)分,差异有统计学意义(P<0.05);治疗3个月后,两组的VAS评分相近(P>0.05)。治疗后,观察组CRP、TNF-α、IL-6水平分别为(29.46±4.21)mg/L、(11.71±1.98)ng/L、(5.93±1.20)ng/L,低于对照组的(35.61±6.89)mg/L、(16.48±2.14)ng/L、(7.84±1.31)ng/L,差异有统计学意义(P<0.05)。结论 负压封闭引流技术灌洗引流联合万古霉素骨水泥链珠植入治疗慢性骨髓炎在抗生素使用时间、切口愈合时间、住院时间、疼痛程度以及炎症指标方面均优于常规引流联合抗生素灌洗治疗,该治疗方案显示出良好的临床疗效,为慢性骨髓炎的治疗提供了一种新的有效治疗方案。Objective To confirm the clinical efficacy of vacuum sealing drainage combined with vancomycin-impregnated bone cement beads in the treatment of chronic osteomyelitis,so as to provide a new treatment plan for chronic osteomyelitis.Methods 88 patients with chronic osteomyelitis were selected.According to different clinical treatment methods,they were divided into a control group(treated with conventional drainage and antibiotic irrigation)and an observation group(treated with vacuum sealing drainage and vancomycin-impregnated bone cement beads),each with 44 cases.Both groups were compared in terms of perioperative indexes(duration of antibiotic use,incision healing time,hospital stay),visual analogue scale(VAS)score and serological indexes[serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)].Results The duration of antibiotic use,incision healing time and hospital stay of the observation group were(18.01±2.52),(29.84±3.76)and(31.22±4.11)d,which were shorter than(28.96±3.91),(42.22±5.37)and(40.84±4.20)d of the control group.The difference was statistically significant(P<0.05).VAS scores of the observation group after 1 and 2 months of treatment were(2.42±1.03)and(2.25±0.98)points,which were lower than(3.14±1.25)and(1.74±0.87)points of the control group,and the difference was statistically significant(P<0.05).After 3 months of treatment,the VAS scores of the two groups were similar(P>0.05).After treatment,the levels of CRP,TNF-αand IL-6 in the observation group were(29.46±4.21)mg/L,(11.71±1.98)ng/L and(5.93±1.20)ng/L,which were lower than(35.61±6.89)mg/L,(16.48±2.14)ng/L and(7.84±1.31)ng/L in the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of vacuum sealing drainage and vancomycin-impregnated bone cement beads for the treatment of chronic osteomyelitis is superior to conventional drainage combined with antibiotic irrigation in terms of duration of antibiotic use,incision healing time and hospital stay,pain level,and

关 键 词：负压封闭引流技术 万古霉素骨水泥链珠 慢性骨髓炎 

分 类 号：R681.2[医药卫生—骨科学]