诱导膜在感染性骨缺损治疗中的作用观察

发布时间：2018-04-17 21:03

  本文选题：诱导膜技术 + 诱导膜　； 参考：《中国临床解剖学杂志》2017年04期

【摘要】：目的探讨诱导膜在感染性骨缺损治疗中的作用。方法 2008年1月~2015年9月,应用万古霉素骨水泥填塞、二期植骨治疗感染性骨缺损38例。分为诱导膜包裹组(A组,24例)和无诱导膜包裹组(B组,14例)。记录骨愈合、感染复发和再次手术干预情况,骨愈合和邻近关节功能分级按Paley方法分别评价。结果随访12~51(平均19.6)个月。A组均一期愈合,临床愈合时间3.0~7.0(平均5.25)个月;B组1例骨不愈合,B组临床愈合时间3.0~15.0(平均6.64)个月。A组术后感染复发1例,B组感染复发3例。B组需要再次手术干预3例,A组无。两组的骨愈合时间和再次手术干预率比较,差异有统计学意义(P0.05),虽然两组感染复发率比较差异无统计学意义(P0.05),但B组感染复发率呈高于A组的趋势。末次随访,两组的骨缺损愈合分级和邻近关节功能恢复比较,差异无统计学意义(P0.05)。结论诱导膜完整性与骨愈合效果有关,负载抗生素骨水泥填塞形成的诱导膜对感染性骨缺损术后感染复发具有一定的隔离保护作用。
[Abstract]:Objective to investigate the role of induction membrane in the treatment of infectious bone defect.Methods from January 2008 to September 2015, 38 cases of infectious bone defects were treated with vancomycin bone cement tamponade and secondary bone graft.Group A (n = 24) and group B (n = 14) were divided into two groups: group A (n = 24) and group B (n = 14).Bone healing, infection recurrence and re-operative intervention were recorded. Bone healing and adjacent joint function grades were evaluated by Paley method.Results all the patients in group A were healed at the first stage after a follow-up of 12 months (mean 19.6 months).The clinical healing time of group B was 3. 0 to 7. 0 (mean 5. 25) months. The clinical healing time of group B was 3. 0 to 15. 0 (mean, 6. 64) months. Group A had 1 recurrence of infection after operation.The time of bone healing and the rate of re-operation intervention were significantly different between the two groups. Although there was no significant difference in the recurrence rate of infection between the two groups, the recurrence rate of infection in group B was higher than that in group A.At the last follow-up, there was no significant difference in the grade of bone defect healing and the functional recovery of adjacent joints between the two groups (P 0.05).Conclusion the integrity of the induced membrane is related to the effect of bone healing. The induced membrane formed by the loading of antibiotic bone cement has a certain protective effect on the recurrence of infection after infectious bone defect.
【作者单位】： 无锡市第九人民医院骨科;常州市第四人民医院骨科;
【分类号】：R687.3
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本文编号：1765267