不同成分骨水泥植入对胫骨慢性骨髓炎患者的临床疗效评价

发布时间：2019-07-12 15:22

【摘要】：目的探讨腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入对胫骨慢性骨髓炎的临床疗效。方法回顾医院2014年1月-2015年2月收治40例胫骨慢性骨髓炎患者的临床资料,根据治疗方案的不同,采用万古霉素硫酸钙骨水泥治疗22例患者为研究组,采用庆大霉素骨水泥(PMMA)治疗18例患者为对照组,两组均给予封闭负压引流以及腓肠神经营养血管皮瓣,观察比较两组治疗疗效以及感染控制情况。结果研究组治疗疗效优良率为95.45%,显著高于对照组72.22%,组间差异有统计学意义(P0.05);研究组感染控制时间2~4.5个月,平均时间(1.9±0.6)个月,对照组感染控制时间3.5~5.5个月,平均时间(3.7±0.2)个月;研究组与对照组感染控制率分别为95.45%和72.22%,差异有统计学意义(P0.05),感染病程分别为(10.2±3.1)个月和(9.9±3.3)个月(P0.05)。结论腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入对胫骨慢性骨髓炎具有更加显著的疗效,患者控制感染所需时间短,并且对于软组织缺损较为严重的胫骨慢性骨髓炎疗效更佳,适合在临床上推广使用。
[Abstract]:Objective To study the clinical effect of the combined with vancomycin calcium sulfate bone cement in the treatment of chronic osteomyelitis of the tibia. Methods The clinical data of 40 patients with chronic osteomyelitis from January 2014 to February 2015 were reviewed. According to the different treatment protocol,22 patients were treated with calcium sulfate and calcium sulfate bone cement as the study group, and 18 patients were treated with gentamicin bone cement (PMMA) as the control group. The two groups were treated with closed negative pressure drainage and sural nerve nutrient vessel flap, and the curative effect and infection control of the two groups were observed. Results The excellent and good rate of the study group was 95.45%, which was significantly higher than that of the control group (72.22%). The control time of the study group was 2-4.5 months, the average time (1.9-0.6) months, the control time of the control group was 3.5-5.5 months, and the average time (3.7-0.2) months; The control rates of infection in the study group and the control group were 95.45% and 72.22%, respectively. The difference was statistically significant (P0.05). The duration of the infection was (10.2-3.1) months and (9.9-3.3) months (P0.05). Conclusion: The treatment of the chronic osteomyelitis of the tibia with the combined vancomycin calcium sulfate bone cement implantation is much more effective in the treatment of chronic osteomyelitis of the tibia, and the effect on the chronic osteomyelitis of the tibia is better than that of the soft tissue defect. Is suitable for clinical popularization and use.
【作者单位】：海南省妇幼保健院小儿骨科;
【基金】：海南省自然科学基金面上资助项目(20168326)
【分类号】：R687.3

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