Ilizarov骨搬运技术治疗长管状骨感染性骨不连的临床研究

发布时间：2019-05-22 16:47

【摘要】：目的：比较Ilizarov骨搬运技术与钢板结合骨移植在治疗长管状骨感染性骨不连的临床疗效，为长管状骨感染性骨不连手术治疗方式的选择提供依据及参考。方法：随访吉大一院创伤骨科在2010年7月至2014年10月期间收治感染性骨不连患者19例,其中男13例，女6例；年龄24～58岁；病程8～30个月；随访时间12～22个月。车祸伤13例，摔伤2例，，重物砸伤2例，高处坠落伤2例。胫骨10例，股骨9例。对这19例患者根据手术方式的不同进行分组:应用Ilizarov骨搬运技术orthfix单臂外固定架治疗（实验组）8例；应用锁定加压钢板（LCP）结合自体骨移植植骨治疗（对照组）11例。对两组患者进行随访，并对收集的资料进行回顾性分析。通过病历记录、电话随访及门诊随访统计患者信息，并对信息进行评估分析。主要观察指标：住院天数、术中累积失血量、部分负重时间、感染控制率、住院费用、再手术率、骨缺损程度、平均手术次数、AAOS评分。数据应用SPSS17.0进行分析处理。结果：实验组患者住院天数、术中累积失血量、部分负重时间、感染控制率、住院费用、再手术率、骨缺损程度、平均手术次数、AAOS评分分别为35.25±9.57d、1348.12±226.05ml、1.91±0.36m、87.5％、70795.87±20385.53RMB、0％、4.50±1.41cm、3.00±1.07次、84.75±1.67；对照组为48.27.40±16.45d、2465.45±666.31ml、2.78±0.58m、72.7％、90204.89±25359.46RMB、27.3％、2.55±1.75cm、4.36±1.57次、80.45±3.30。两组比较差异有统计学意义（P＜0.05）。实验组在以上方面优于对照组。结论： 1.Ilizarov骨搬运技术治疗长管状骨感染性骨不连疗效显著，感染控制率高。 2.Ilizarov骨搬运技术对于软组织条件要求较低，能够有效保护软组织，促进其恢复,为肢体恢复长度提供保障。 3.实验组病例数较少，需继续完善统计学资料，进行进一步研究。
[Abstract]:Objective: to compare the clinical efficacy of Ilizarov bone handling technique and plate combined bone transplantation in the treatment of long tubular bone infectious nonunion, and to provide basis and reference for the choice of surgical treatment of long tubular bone infectious nonunion. Methods: from July 2010 to October 2014, 19 patients with infectious nonunion were followed up in the Department of Trauma Orthopaedics, Jida Hospital, including 13 males and 6 females, aged 24 years and 58 years, the course of disease was 8 times 30 months, and the follow-up time was 12 months and 22 months. There were 13 cases of car accident injury, 2 cases of fall injury, 2 cases of heavy object injury and 2 cases of falling injury. There were 10 cases of tibia and 9 cases of femurs. The 19 patients were divided into two groups according to the different surgical methods: 8 cases were treated with Ilizarov bone transport technique orthfix single arm external fixation (experimental group), 11 cases were treated with locking compression plate (LCP) combined with autologous bone grafting (control group). The patients in the two groups were followed up and the collected data were analyzed retrospectively. The patient information was counted by medical record, telephone follow-up and outpatient follow-up, and the information was evaluated and analyzed. Main outcome measures: hospitalization days, cumulative blood loss during operation, partial load-bearing time, infection control rate, hospitalization expenses, reoperation rate, bone defect degree, average operation times, AAOS score. The data are analyzed and processed by SPSS17.0. Results: in the experimental group, the hospitalization days, cumulative blood loss, partial load time, infection control rate, hospitalization expenses, reoperation rate, bone defect degree, average operation frequency and AAOS score were 35.25 卤9.57 days, respectively. 1348.12 卤226.05ml, 1.91 卤0.36m, 87.5%, 70795.87 卤20385.53 RMB, 0%, 4.50 卤1.41cm, 3.00 卤1.07 times, 84.75 卤1.67 times; The control group was 48.27.40 卤16.45d, 2465.45 卤666.31ml, 2.78 卤0.58m, 72.7%, 90204.89 卤25359.46, RMB 27.3%, 2.55 卤1.75cm, 4.36 卤1.57 times, 80.45 卤3.30 times. There was significant difference between the two groups (P < 0.05). The experimental group was superior to the control group in the above aspects. Conclusion: 1.Ilizarov bone transport technique is effective in the treatment of infectious nonunion of long tubular bone, and the infection control rate is high. 2.Ilizarov bone transportation technology has low requirements for soft tissue conditions, which can effectively protect soft tissue, promote its recovery, and provide a guarantee for limb recovery length. 3. The number of cases in the experimental group is small, so it is necessary to continue to improve the statistical data and carry out further research.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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