中西医结合改良Ilizarov术对下肢感染性骨缺损和肢体短缩的临床疗效

发布时间：2018-03-03 00:25

本文选题：Ilizarov　切入点：下肢感染性骨缺损　出处：《中国老年学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的探讨中西医结合改良Ilizarov术对下肢感染性骨缺损(LEIBD)和肢体短缩的临床疗效。方法 40例LEIBD患者按照不同疗法分为两组,采用西药结合改良Ilizarov术为对照组18例,在对照组的基础上辅助中医治疗患者22例为中药组。分析两组疗法对骨缺损和肢体短缩的临床疗效。结果经过4~6 w抗感染治疗,随访6~18个月,患者炎症都治愈。10例股骨患者在术后9例两下肢均衡发展等长,可负重行走。30例胫骨患者28例两下肢等长,两下肢短缩0.5 cm,较满意。中药组治疗率高于对照组,但差异无统计学意义(P0.05),愈合期显著低于对照组(P0.05),同时手术次数也相对较少。9例股骨患者在术后髋关节功能均正常,7例表现僵硬,3例可以屈伸,其中中药组正常率高于对照组,但差异无统计学意义(P0.05);30例胫骨患者28例膝关节功能正常,2例轻度屈伸受限,其中中药组正常率高于对照组(P0.05);3例踝关节融合,15例踝关节功能正常,1例部分屈伸障碍,其中中药组正常率高于对照组,但差异无统计学意义(P0.05)。中药组钉眼异常、轴向偏移、多发性关节挛缩症及松动均低于对照组,并发症率低。结论采用中西医结合改良Ilizarov术对LEIBD和肢体短缩的临床疗效突出,骨愈合率高,并发症少。
[Abstract]:Objective to investigate the clinical effect of modified Ilizarov in the treatment of infective bone defect of lower extremity and limb shortening. Methods 40 patients with LEIBD were divided into two groups according to different treatments, and 18 patients were treated with western medicine combined with modified Ilizarov as control group. On the basis of the control group, 22 patients were treated with traditional Chinese medicine (TCM). The clinical efficacy of the two groups in the treatment of bone defect and limb shortening was analyzed. Results after 4 weeks of anti-infection therapy, the patients were followed up for 6 ~ 18 months. Inflammation was cured in all the 10 cases of femur. After operation, 9 cases of femur developed equably long, 28 cases of tibia could walk with weight bearing, 28 cases had equal length of lower extremity and 0.5 cm of shortening of lower extremities, the treatment rate of Chinese herbal medicine group was higher than that of control group, and the treatment rate of Chinese medicine group was higher than that of control group. However, the difference was not statistically significant (P 0.05), and the healing period was significantly lower than that in the control group (P 0.05). At the same time, the number of times of operation was also relatively small in 7 cases with normal hip joint function and 7 cases with stiffness after operation. The normal rate in the Chinese medicine group was higher than that in the control group. However, there was no significant difference between 30 patients with tibia and 28 patients with normal knee joint function and 2 patients with mild flexion and extension limitation. The normal rate in the Chinese medicine group was higher than that in the control group (P 0.05), 3 cases of ankle fusion and 15 cases of ankle joint function were normal and 1 case had partial flexion and extension disorder. The normal rate of TCM group was higher than that of control group, but the difference was not statistically significant (P 0.05). The nail-eye abnormality, axial deviation, multiple joint contracture and loosening in TCM group were lower than those in control group. Conclusion modified Ilizarov combined with traditional Chinese and Western medicine is effective in the treatment of LEIBD and limb shortening. The rate of bone healing is high and the complications are less.
【作者单位】：武汉市第三医院骨科;
【基金】：武汉市卫生局科研项目(No.WX11C15)
【分类号】：R687.3

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