采用抗生素局部介入治疗慢性骨髓炎  

The Treatment of Chronic Osteomyelitis with Injection Antibiotics by Interventional Therapy

作　　者：刘兴炎[1] 葛宝丰[1] 甄平[1] 傅晨[1] 高秋明[1] 樊晓海[1] 

机构地区：[1]兰州军区兰州总医院骨科,兰州市730050

出　　处：《骨与关节损伤杂志》2003年第9期605-606,共2页The Journal of Bone and Joint Injury

摘　　要：目的 探索抗生素局部介入治疗慢性骨髓炎的疗效。方法 采用微量注射泵内抗生素持续局部给药方法治疗非明显死骨形成慢性骨髓炎33例。结果 用药时间7～21d,于用药当天开始肢体疼痛减轻、局部肿胀逐渐消退、皮肤色泽由黑红转暗红直至正常,窦道脓液渗出减少变为稀薄,直至干燥、结痂而愈合;全身中毒症状完全消除,经8～32个月随访未见复发。结论 随着影像介入技术应用,敏感抗生素在病灶持续应用成为可能,采用微量注射泵持续给药方式,可保持病灶内高血药浓度状态7～21d,在此间可依据致病菌对抗生素不同敏感性进行调配,使病灶区内始终保持足量、敏感抗生素的内环境,从而更直接促进炎症吸收、消除、转归,为新生组织修复创造条件,与抗生素全身给药相比,其抗生素弥散迅速、持久、吸收完全,因而对反复发作又未见明显死骨形成的骨与软组织感染,实为较确实治疗途径。Objective To probe the treatment results of chronic osteomyelitis with injection antibiotics by interventional therapy. Methods By injection with perfusor compact,33 cases of chronic osteomyelitis with forming of unconspicuous dead bone were treated with continually injecting antibiotics by interventional therapy. Results The times of injecting antibiotics by interventional therapy were 7-21 days. Since the first day of injecting antibiotics began, pain was alleviated in body, black were turned to norual in the skin color, pus effusion were decreased to rarefaction in sinuses,sinuses were dried to scab and were cured,the symptom were entirety relieved by follow-up 8-32 months, there were not recrudescencing in all patients. Conclusion With application of intervention radiology technique, that sensitivity antibiotics were continually injected by intervention therapy were become possibility, seven to twenty one days of high level of antibiotics in blood were maintained in the lesion area by therapy of continually injecting antibiotics with perfusor compact.During the time,the antibiotics were changed according the sensitivity of bacteria in the lesion area. There were so interior surroundings,high sufficiency and sensitivity antibiotics were always retained in the lesion area that absorbent and elimination of inflammation were directly improved and the repair condition of cambium were created. By comparison with injection antibiotics in vein,dispersion velocity,maintenance and completeness absorbent of injection antibiotics by intervention therapy were better. Therefore,the treatment with injection antibiotics by interventional therapy for bone and parenchyma infection with reiteration outbreak and forming of inconspicuous dead bone were more positively treatment approach.

关 键 词：抗生素 局部介入治疗 慢性骨髓炎 疗效观察 

分 类 号：R681.2[医药卫生—骨科学]