载抗生素硫酸钙人工骨治疗慢性骨髓炎及其细菌学分析

发布时间：2018-05-29 09:33

本文选题：慢性骨髓炎 + 硫酸钙　；参考：《中国病原生物学杂志》2017年05期

【摘要】：目的探讨病灶清除和载万古霉素硫酸钙人工骨植入对慢性化脓性骨髓炎的治疗效果。方法慢性化脓性骨髓炎患者48例,行病灶彻底清除手术治疗后分别应用加载万古霉素硫酸钙人工骨植入(A组)及传统抗生素灌洗(B组)治疗,观察2组患者治疗效果;对创面进行细菌培养,观察患者创口愈合情况,对植骨处进行X线片检查。结果患者术后随访6~48个月,平均随访时间为14个月。A组24例患者平均刀口愈合时间为(15.17±0.76)d,平均住院时间为(26.17±3.56)d,其中治愈18例,好转4例,有效率91.67%,未愈2例(占8.33%)。B组24例患者平均刀口愈合时间为(16.63±7.35)d,平均住院时间为(39.79±4.55)d,其中治愈12例,好转4例,有效率66.67%,未愈8例(占33.33%)。A组X线片检查显示,术后1d硫酸钙人工骨颗粒充满骨髓腔,硫酸钙颗粒间隙好;术后平均3周肢体X光片检查硫酸钙人工骨颗粒间隙模糊,部分硫酸钙开始吸收;术后4个月人工骨颗粒阴影消失;术后6个月植骨区成骨明显,骨痂连续,感染性骨不连完全愈合。结论载万古霉素硫酸钙骨治疗慢性骨髓炎疗效确切,能有效防止骨髓炎复发,促进创面愈合,且有一期骨引导作用,符合骨髓炎治疗要求,具有临床推广意义。
[Abstract]:Objective to investigate the therapeutic effect of focal debridement and vancomycin calcium sulfate artificial bone implantation on chronic suppurative osteomyelitis. Methods 48 patients with chronic suppurative osteomyelitis were treated with vancomycin calcium sulfate artificial bone implantation (group A) and traditional antibiotic lavage (group B) after radical debridement. The wound was cultured, the wound healing was observed, and the bone graft was examined by X-ray. Results the average follow-up time was 14 months. The average time of knife wound healing was 15.17 卤0.76 days, and the average hospitalization time was 26.17 卤3.56 days. Among them, 18 cases were cured and 4 cases improved. The effective rate was 91.67 and the effective rate was 91.67. The average healing time of the knife wound was 16.63 卤7.35 days and the average hospitalization time was 39.79 卤4.55 days in 24 patients in group B (8.333.B). Among them, 12 cases were cured, 4 cases were improved, the effective rate was 66.67, and 8 cases were not recovered (33.33.A group). The calcium sulfate artificial bone granules were filled with medullary cavity at 1 day after operation, the gap of calcium sulfate granules was good, the average limb X-ray examination was 3 weeks after operation, the gap of calcium sulfate artificial bone granules was blurred, part of calcium sulfate began to absorb, and the shadow of artificial bone particles disappeared 4 months after operation. 6 months after operation, the bone graft area was obviously osteogenic, the callus was continuous, and the infectious bone nonunion healed completely. Conclusion Vancomycin calcium sulfate bone is effective in the treatment of chronic osteomyelitis, which can effectively prevent the recurrence of osteomyelitis and promote wound healing.
【作者单位】：济宁医学院附属医院创伤骨科;济宁医学院临床医学院;
【基金】：山东省自然科学基金项目(No.ZR2015HL027)
【分类号】：R687.3

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