负压封闭引流技术用于胫骨骨折内固定术后早期感染临床观察

发布时间：2019-02-16 07:53

【摘要】：目的探讨负压封闭引流技术(VSD)治疗胫骨骨折内固定术后早期感染的临床效果及安全性。方法选择胫骨骨折内固定术后早期感染患者25例,随机分为观察组13例和对照组12例。观察组保留内固定装置并给予VSD治疗,对照组取出内固定装置、改用外固定架固定并给予换药治疗,两组术后均给予敏感抗生素抗感染治疗,疗程均为6周。记录两组皮肤切口及骨性愈合时间,术前及术后1、2、3周WBC、CRP、血沉(ESR)及血清降钙素原水平变化,术后3周引流不畅及感染加重需再次清创情况。结果观察组与对照组皮肤愈合时间分别为(22.5±1.9)、(48.3±3.0)d,骨性愈合时间分别为(8.6±1.4)、(9.4±1.8)个月,两组比较P均0.05。与术前比较,两组术后1、2、3周WBC、CRP、ESR及血清降钙素原水平均降低,但观察组术后3周上述指标降低更明显(P均0.05)。观察组引流不畅1例(7.69%),无再次清创者;对照组引流不畅3例,行再次清创者3例。结论 VSD用于胫骨骨折内固定术后早期感染患者临床效果较好,安全性较高。
[Abstract]:Objective to evaluate the efficacy and safety of (VSD) in the treatment of early infection after internal fixation of tibial fractures. Methods Twenty-five patients with early infection after internal fixation of tibial fractures were randomly divided into observation group (n = 13) and control group (n = 12). In the observation group, the internal fixation device was retained and treated with VSD. In the control group, the internal fixator was removed and the external fixator was used to fix and change the medicine. The two groups were treated with sensitive antibiotics and anti-infection therapy for 6 weeks after operation. The time of skin incision and bone healing, the changes of WBC,CRP, erythrocyte sedimentation rate (ESR) and serum procalcitonin (procalcitonin) levels before operation and 1 ~ 2 weeks after operation were recorded. Results the healing time of skin and bone were (22.5 卤1.9), (, 48.3 卤3.0) d, (8.6 卤1.4), (, 9.4 卤1.8) months, respectively (P 0.05). Compared with pre-operation, WBC,CRP,ESR and serum calcitonin in the two groups decreased on average at 1 and 2 weeks postoperatively, but the above indexes decreased more significantly in the observation group at 3 weeks after operation (all P 0.05). In the observation group, 1 case (7.69%) had no re-debridement, while 3 cases in the control group had no re-debridement. Conclusion VSD is a safe and effective method for early infection of tibial fractures.
【作者单位】：天津市人民医院;天津医科大学内分泌研究所;
【基金】：天津市卫生局科技基金项目(2014KZ055)
【分类号】：R687.3

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