骨开窗减压引流术治疗儿童急性长骨骨髓炎的效果及对炎症因子水平的影响  

Efficacy of bone window decompression and drainage in treating acute long bone osteomyelitis in children and its impact on inflammatory factor levels

作　　者：王军建 孙克明 张春旭 李振威 郭占豪 程坦[1] WANG Jun-jian;SUN Ke-ming;ZHANG Chun-xu;LI Zhen-wei;GUO Zhan-hao;CHENG Tan(Department of Orthopedics,Children's Hospital Affiliated of Zhengzhou University(Henan Children's Hospital,Zhengzhou Children's Hospital),Zhengzhou 450018,Henan,CHINA)

机构地区：[1]郑州大学附属儿童医院(河南省儿童医院郑州儿童医院)骨科,河南郑州450018

出　　处：《海南医学》2025年第7期976-980,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关联合共建项目(编号:LHGJ20220714)。

摘　　要：目的探讨骨开窗减压引流术治疗急性长骨骨髓炎患儿的效果及对炎症因子水平的影响。方法回顾性分析2018年4月至2023年1月郑州大学附属儿童医院收治的60例急性长骨骨髓炎患儿的临床资料,依据不同手术方法分组,其中27例采用钻孔减压引流术治疗者纳入对照组,33例采用骨开窗减压引流术治疗者纳入观察组,两组患儿治疗出院后均随访6个月。出院前,比较两组患儿负压封闭引流术(VSD)装置去除时间、体温恢复时间和住院时间;术前及术后5 d,比较两组患儿的超敏-C反应蛋白(hs-CRP)、白介素-1β(IL-1β)、白细胞计数(WBC)、血沉(ESR)水平;随访6个月后,比较两组患儿的临床疗效和并发症发生情况。结果观察组患儿的VSD装置去除时间、体温恢复时间、住院时间分别为(6.69±0.61)d、(3.02±0.44)d、(9.79±1.05)d,明显短于对照组的(8.84±0.90)d、(5.70±0.71)d、(12.80±2.01)d,差异均有统计学意义(P<0.05);术前,两组患儿炎症因子水平比较差异无统计学意义(P>0.05),术后5 d,两组患儿的炎症因子水平均较术前下降,且观察组患儿的hs-CRP、IL-1β、WBC及ESR水平分别为(12.59±1.04)mg/L、(10.02±1.64)pg/m L、(6.59±0.80)×10^(9)/L、(10.80±1.63)mm/h,明显低于对照组的(18.77±1.60)mg/L、(16.79±2.05)pg/mL、(11.04±1.26)×10^(9)/L、(16.49±2.26)mm/h,差异均有统计意义(P<0.05);随访6个月后,观察组患儿的优良率为96.97%,略高于对照组的88.89%,但差异无统计学意义(P>0.05);两组患儿术后均无切口感染、神经损伤等并发症发生。结论骨开窗减压引流术是治疗小儿急性长骨骨髓炎的安全、有效方式,能够缩短患儿恢复时间,降低炎症因子水平。Objective To investigate the efficacy of bone window decompression and drainage in treating acute long bone osteomyelitis in children and its impact on inflammatory factor levels.Methods A retrospective analysis was conducted on the clinical data of 60 children with acute long bone osteomyelitis admitted to the Children's Hospital Affiliated of Zhengzhou University from April 2018 to January 2023.Based on different surgical methods,the patients were divided into two groups:27 children treated with drilling decompression and drainage were included in the control group,and 33 children treated with bone window decompression and drainage were included in the observation group.Both groups were followed up for 6 months after discharge.Before discharge,the time to removal of the vacuum sealing drainage(VSD)device,time to body temperature recovery,and hospitalization duration were compared between the two groups.Levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),white blood cell count(WBC),and erythrocyte sedimentation rate(ESR)were compared before surgery and 5 days after surgery.After 6 months of follow-up,clinical efficacy and complication rates were compared between the two groups.Results The time to VSD device removal,body temperature recovery,and hospitalization duration in the observation group were(6.69±0.61)days,(3.02±0.44)days,and(9.79±1.05)days,respectively,significantly shorter than(8.84±0.90)days,(5.70±0.71)days,and(12.80±2.01)days in the control group(P<0.05).Preoperatively,there were no significant differences in inflammatory factor levels between the two groups(P>0.05).Five days postoperatively,inflammatory factor levels decreased in both groups,with the observation group showing significantly lower levels of hs-CRP,IL-1β,WBC,and ESR compared to the control group:(12.59±1.04)mg/L,(10.02±1.64)pg/mL,(6.59±0.80)×10^(9)/L,and(10.80±1.63)mm/h vs(18.77±1.60)mg/L,(16.79±2.05)pg/mL,(11.04±1.26)×10^(9)/L,and(16.49±2.26)mm/h,P<0.05.After 6 months of follow-up,the excellen

关 键 词：急性长骨骨髓炎 骨开窗减压 钻孔减压 疗效 炎症因子 

分 类 号：R725.5[医药卫生—儿科]