负压封闭引流技术联合骨搬移对创伤后骨感染的效果分析
摘要
目的探讨负压封闭引流技术联合骨搬移对创伤后骨感染的治疗效果。方法回顾性分析我院2010年1月至2015年1月收治的80例经负压封闭引流技术联合骨搬移治疗的胫骨创伤后骨感染患者的临床资料,术前均给予细菌培养、药敏试验以及三维CT检查,术后对患者的骨修复以及功能恢复状况采用Ilizarov方法研究与应用学会(ASAMI)分类标准进行分析评价。结果 80例骨感染患者均完全治愈,病灶清除后残留的骨缺损、骨不连、骨腔等病变部位均得到相应修复,患者骨感染平均愈合时间为5.34个月。患者骨延长为3.02～9.81 cm,平均延长5.27 cm,延长区均表现为骨性愈合,所有患者的肢体长度均达到预期。另患肢功能恢复评定:有18例中,26例良,36例优,优良率为77.50%。骨修复评定:7例中,29例良,44例优,优良率为91.25%。结论负压封闭引流技术联合骨搬移治疗创伤后骨感染具有促进骨修复和抗感染的作用,术后肢体功能恢复较好,可以显著降低治疗时间,是骨感染患者治疗较为理想的方法,值得临床推广使用。
引文
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[2] Inzana J A,Schwarz E M,Kates S L,et al.A novel murine model of established staphylococcal bone infection in the presence of a fracture fixation plate to study therapies utilizing antibiotic-iaden spacers after revision surgery[J].Bone,2015,72(3):128-136.
[3] Arteagoitia I,Ramos E,Santamaria G,et al.Amoxicillin/clavulanic acid 2000/125 mg to prevent complications due to infection following completely bone-impacted lower third molar removal:a clinical trial[J].Oral Surgery Oral Medicine Oral Pathology & Oral Radiology,2015,119(1):8-16.
[4] Chenery A L,Antignano F,Hughes M R,et al.Chronic Trichuris muris infection alters hematopoiesis and causes IFN-γ-expressing T cell accumulation in the mouse bone marrow[J].European Journal of Immunology,2016,46(11):2587-2596.
[5] 吴信,尚显文,张皓,等.抗生素联合负压封闭引流治疗腰椎内固定术后早期切口深部感染10例分析[J].贵州医药,2015,39(12):1107-1109.
[6] Tricard T,Bund L,Alhefzi A,et al.Eikenella corrodens bone and hip joint infection.A case report and literature review[J].Archives de pediatrie :organe officiel de la Societe francaise de pediatrie,2016,23(11):1146-1149.
[7] 徐斌,盛加根,刘亮,等.负压封闭引流联合开放性植骨术或骨搬移术治疗胫骨创伤性骨髓炎[J].国际骨科学杂志,2015,36(4):314-319.
[8] 张彦龙,王泳,彭阿钦.骨搬移联合开放植骨和负压封闭引流技术治疗胫骨感染性骨缺损[J].中华创伤杂志,2017,33(2):141-146.
[9] Hilliard C A,Masri J E,Goto M.Staphylococcus capraebacteraemia and native bone infection complicated by therapeutic failure and elevated MIC:a case report:[J].Jmm Case Reports,2017,4(9):52-63.
[10] 潘洪,赵志芳,楼肃亮,等.跟骨骨折切开复位内固定术后创口感染影响因素分析[J].浙江医学,2016,38(23):1946-1948.
[11] 杨文峰,张铁慧,梁武,等.VSD联合Ilizarov外固定架骨搬移技术治疗胫骨骨折伴软组织缺损的效果分析[J].中国矫形外科杂志,2017,25(24):2282-2285.
[12] Ferry T,Laurent F,Ragois P,et al.Post-traumatic chronic bone and joint infection caused by Butyricimonas spp,and treated with high doses of ertapenem administered subcutaneously in a 30-year-old obese man[J].Bmj Case Reports,2015,2015(1):212-223.
[13] 杨广钢,苏博源,潘永雄,等.负压封闭引流技术联合游离植皮治疗跟骨术后感染的疗效观察[J].重庆医学,2018,47(1):117-119.
[14] Liu Z,Zhao D,Wang B.Improved vacuum sealing drainage in the treatment of gas gangrene:a case report[J].International Journal of Clinical & Experimental Medicine,2015,8(10):19626-19628.
[15] 焦晓虎,王福顺,焦晨炜.负压封闭引流技术应用于治疗难治性骨感染[J].骨科,2017,8(2):103-106.