可吸收载抗菌药物硫酸钙与生物骨水泥链珠膜诱导在儿童足跟组织缺损合并创伤性跟骨骨髓炎中的效果比较  

Comparison of the Effect of Antibiotic-Loaded Absorbable Calcium Sulfate and Biological Bone Cement Chain Bead Membrane Induction in Children with Heel Tissue Defect Complicated with Traumatic Calcaneal Osteomyelitis

作　　者：宋东建[1,2] 甘君龄 苏萌 刘秋亮[1] SONG Dong-jian;GAN Jun-ling;SU Meng;LIU Qiu-liang(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Institute of Molecular Cancer Surgery,Zhengzhou University,Henan Province Engineering Research Center,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院小儿外科,郑州450000 [2]郑州大学肿瘤分子外科研究所、河南省肿瘤分子外科工程研究中心,郑州450000

出　　处：《中国合理用药探索》2024年第7期52-61,共10页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200323);河南省高等学校重点科研项目(20B320023);河南省中青年卫生健康科技创新优秀青年人才培养项目(YXKC2021060)。

摘　　要：目的:探讨可吸收载抗菌药物硫酸钙与生物骨水泥链珠膜诱导在儿童足跟组织缺损合并创伤性跟骨骨髓炎中的效果。方法:选取2018年1月~2022年12月期间某院收治的96例儿童足跟组织缺损合并创伤性跟骨骨髓炎患儿作为研究对象,根据手术方式不同分为对照组(n=54)和观察组(n=42)。对照组患儿采用合理皮瓣修复后联合生物骨水泥链珠膜诱导治疗,观察组患儿采用合理皮瓣修复后联合可吸收载抗菌药物硫酸钙治疗。比较两组患儿创面分泌物细菌培养、感染性指标[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)、白细胞计数(WBC)、红细胞沉降率(ESR)]、视觉模拟评分法(VAS)评分、住院时间、愈合时间、并发症、感染复发率及对照组患儿再次手术情况。结果:两组患儿创面分泌物细菌培养结果提示,均以金黄色葡萄球菌为主。术后7天、14天,两组患儿WBC、ESR、IL-6、IL-8、TNF-α均降低(P<0.05),且观察组低于对照组(P<0.05)。术后1、3个和6个月,两组患儿VAS评分均降低(P<0.05),观察组患儿术后1、3个月VAS评分低于对照组(P<0.05),两组患儿术后6个月VAS评分比较无统计学差异(P>0.05)。观察组患儿住院、愈合时间均短于对照组(P<0.05)。两组患儿并发症总发生率、术后6个月感染复发率比较均无统计学差异(P>0.05)。对照组患儿均需要再次手术取出骨水泥链珠,其中9例患儿再次接受骨水泥植入。结论:合理皮瓣修复后联合可吸收载抗菌药物硫酸钙治疗可更有效减轻患儿疼痛,抑制炎症反应,促进术后康复和骨愈合。Objective:To investigate the effect of antibiotic-loaded absorbable calcium sulfate versus biological bone cement chain bead membrane induction in children with heel tissue defect complicated with traumatic calcaneal osteomyelitis.Methods:A total of 96 children with heel tissue defect complicated with traumatic calcaneal osteomyelitis treated in a hospital from January 2018 to December 2022 were selected and divided into control group(n=54)and observation group(n=42)according to the surgical procedure.The control group was treated with reasonable flap repair combined with biological bone cement chain bead membrane induction,and the observation group was treated with reasonable flap repair combined with antibiotic-loaded absorbable calcium sulfate.Bacterial culture of wound secretion,infection indicators[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),white blood cell count(WBC),erythrocyte sedimentation rate(ESR)],visual analogue scale(VAS)score,duration of hospitalization,healing time,complications,infection recurrence rate and reoperation situation were compared between the two groups.Results:The results of bacterial culture of wound secretion showed that Staphylococcus aureus was the predominant bacteria in both groups.The WBC,ESR,IL-6,IL-8 and TNF-αwere decreased in both groups at 7 days and 14 days after operation(P<0.05),and were lower in the observation group compared with the control group(P<0.05).The VAS score was decreased in both groups at 1,3 and 6 months after operation(P<0.05),and was lower in the observation group compared with the control group at 1 and 3 months after operation(P<0.05).There was no statistically significant difference in the VAS score at 6 months after operation between the two groups(P>0.05).The duration of hospitalization and healing time in the observation group were shorter than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of complications and the infection recurrence rate of 6 months afte

关 键 词：可吸收载抗菌药物硫酸钙 生物骨水泥链珠膜 足跟组织缺损 创伤性跟骨骨髓炎 骨愈合 

分 类 号：R681.2[医药卫生—骨科学]