万古霉素硫酸钙与灌注冲洗治疗慢性骨髓炎的临床分析

发布时间：2018-05-30 18:48

本文选题：慢性骨髓炎 + 万古霉素硫酸钙　；参考：《山东中医药大学》2015年硕士论文

【摘要】：目的:通过对万古霉素硫酸钙与灌注冲洗在慢性骨髓炎治疗中的临床观察,探讨万古霉素硫酸钙与灌注冲洗两种治疗方式治疗慢性骨髓炎的差异及临床疗效。方法:回顾性分析2012年1月至2014年7月间山东中医药大学第一附属医院骨科收治的32例慢性骨髓炎患者的临床资料。以随机分组方式将样本患者资料分为万古霉素硫酸钙治疗组16例,灌注冲洗治疗组16例。分别以相应的治疗方式进行手术。术后观察指标包括:两组手术时间、术中出血量、VAS评分、刀口愈合时间、术后下地时间、住院时间、治疗疗效评价、复发率等。所得数据采用统计软件SPSS17.0进行分析。结果:本次研究共采集病例32例,所有病例皆获得随访。采用万古霉素硫酸钙治疗的16位患者平均刀口愈合时间为13.56±1.31天,24h、48h VAS评分为4.56±0.94分和4.63±0.62分,术后下地时间为13.19±3.78天,平均住院天数为23.69±10.54天,其中1例发生骨折未愈合,5例好转。疗效评价结果为:治愈10例,好转5例,复发率为6.25%。采用灌注冲洗治疗的16位患者平均刀口愈合时间为15.19±2.07天,24h、48h VAS评分为5.19±0.66分和6.06±0.93分,术后下地时间为22.13±4.47天,平均住院天数为40.31±24.78天,其中4例术后刀口发生感染,形成窦道并窦道流脓,2例刀口肿胀伴疼痛,1例发生骨折未愈合,4例好转。疗效评价结果为:治愈5例,好转4例,复发率为43.75%。结论:本次研究表明,相较于灌注冲洗方式治疗慢性骨髓炎,万古霉素硫酸钙在治疗中具有刀口愈合快、术后下地时间早、住院时间短、早期视觉疼痛(VAS)评分低、复发率低、疗效显著等优点。
[Abstract]:Objective: to investigate the difference and clinical effect of vancomycin calcium sulfate and perfusion irrigation in the treatment of chronic osteomyelitis. Methods: the clinical data of 32 patients with chronic osteomyelitis admitted to the Department of Orthopaedics of the first affiliated Hospital of Shandong University of traditional Chinese Medicine from January 2012 to July 2014 were retrospectively analyzed. Patients were randomly divided into vancomycin calcium sulfate treatment group (16 cases) and irrigation treatment group (16 cases). The operation was carried out by corresponding treatment. The indexes of postoperative observation included: operation time, intraoperative bleeding volume and VAS score, wound healing time, postoperative floor time, hospitalization time, curative effect evaluation, recurrence rate and so on. The data were analyzed by statistical software SPSS17.0. Results: 32 cases were collected and all cases were followed up. The average knife healing time of 16 patients treated with vancomycin calcium sulfate was 13.56 卤1.31 days and 24h / 48h VAS score was 4.56 卤0.94 and 4.63 卤0.62respectively. The time of landing was 13.19 卤3.78 days and the average hospital stay was 23.69 卤10.54 days. The results showed that 10 cases were cured, 5 cases improved, and the recurrence rate was 6.25%. The average wound healing time was 15.19 卤2.07 days and 24h / 48h VAS score was 5.19 卤0.66 and 6.06 卤0.93, respectively. The time of landing was 22.13 卤4.47 days and the average hospital stay was 40.31 卤24.78 days. Formation of sinus tract and drainage of sinus canal. 2 cases of swelling of knife edge with pain and 1 case of unhealed fracture were improved in 4 cases. The results showed that 5 cases were cured, 4 cases improved, and the recurrence rate was 43.75%. Conclusion: compared with the treatment of chronic osteomyelitis by perfusion irrigation, vancomycin calcium sulfate has the advantages of quick healing of knife edge, early landing time, short hospital stay, low visual pain score and low recurrence rate. The curative effect is remarkable and so on.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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