不同外科治疗方案在胫骨慢性骨髓炎症感染及软组织缺损患者的疗效对比

发布时间：2018-07-25 17:41

【摘要】：目的探讨不同外科治疗方案在胫骨慢性骨髓炎症感染和软组织缺损患者中的疗效。方法选取2006年1月-2015年10月在医院住院治疗的胫骨慢性骨髓炎症感染和软组织缺损的患者86例,将患者随机分为传统治疗组和联合治疗组,每组43例,传统治疗组患者给予传统外科治疗,联合治疗组给予负压封闭引流联合腓肠肌皮瓣治疗方案,比较两组患者的治疗效果,治疗前后C-反应蛋白含量变化,随访12个月后复发率,统计治疗前后两组患者的病原菌分布。结果联合治疗组治愈率显著高于传统治疗组,联合治疗组治愈时间显著低于传统治疗组,治疗后72h,联合治疗组患者C-反应蛋白含量显著低于传统治疗组,差异具有统计学意义(P0.05);随访12个月后,联合治疗组骨髓炎复发率和继发感染率显著低于传统治疗组,差异具有统计学意义;治疗后,联合治疗组继发感染1例,传统治疗组继发感染13例。结论负压封闭引流联合腓肠肌皮瓣治疗方案应用于慢性骨髓炎症感染和软组织缺损患者的治疗可以提升治愈率,缩短治愈时间、降低炎症反应、复发率和继发感染率。
[Abstract]:Objective to evaluate the efficacy of different surgical treatments in patients with chronic tibial bone marrow inflammation and soft tissue defect. Methods from January 2006 to October 2015, 86 patients with chronic tibial bone marrow inflammatory infection and soft tissue defect were randomly divided into traditional treatment group and combined treatment group with 43 cases in each group. The patients in the traditional treatment group were treated with traditional surgical treatment, and the patients in the combined treatment group were treated with negative pressure closed drainage combined with gastrocnemius myocutaneous flap. The therapeutic effects, the changes of C-reactive protein content and the recurrence rate after 12 months follow-up were compared between the two groups. The distribution of pathogenic bacteria in the two groups before and after treatment was statistically analyzed. Results the cure rate of the combined treatment group was significantly higher than that of the traditional treatment group, the cure time of the combined treatment group was significantly lower than that of the traditional treatment group, and the content of C-reactive protein in the combined treatment group was significantly lower than that in the traditional treatment group at 72 hours after treatment. After 12 months follow-up, the recurrence rate and secondary infection rate of osteomyelitis in the combined treatment group were significantly lower than those in the traditional treatment group, and the difference was statistically significant. 13 cases of secondary infection in traditional treatment group. Conclusion negative pressure sealing drainage combined with gastrocnemius flap can improve the cure rate, shorten the cure time, reduce the inflammatory reaction, recurrence rate and secondary infection rate in patients with chronic bone marrow inflammatory infection and soft tissue defect.
【作者单位】：山东省邹城市人民医院;济宁市第一人民医院;
【分类号】：R687.3

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