摘要
目的探讨抗生素骨水泥对肱骨外科颈骨折术后髓内感染患者血沉、血清炎症指标的影响。方法选取2017年7月-2019年7月某院收治的肱骨外科颈骨折术后髓内感染患者64例,随机分为观察组与常规组,每组32例。常规组给以抗生素持续灌注冲洗治疗,观察组给以抗生素骨水泥治疗,比较两组治疗后24 h、72 h及7 d时血沉(erythrocyte sedimentation rate,ESR)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(interleukin 6,IL-6)、白细胞数(white blood cells,WBC)、中性粒细胞数(neutrophil counts,NEUT)水平以及急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分。结果治疗后24 h时,两组ESR、hs-CRP、IL-6、WBC、NEUT水平差异均无统计学意义(t=-0.026、0.123、0.187、0.235、0.064,P>0.05)。治疗后72 h时,两组ESR、hs-CRP、NEUT水平较24 h时显著升高(常规组:t=-6.797、-4.948、-5.629;观察组:t=-3.453、-3.473、-2.081),7 d后显著降低(常规组:t=3.097、5.831、2.564;观察组:t=12.859、7.178、5.746),差异有统计学意义(P<0.05);治疗后72 h、7 d时,两组IL-6、WBC水平较治疗24 h后均显著降低,差异有统计学意义(治疗后72 h,常规组:t=2.396、1.768,观察组:t=2.696、2.045;治疗后7 d,常规组:t=6.334、3.066,观察组:t=8.756、4.703,P<0.05)。观察组治疗72 h后,ESR、hs-CRP、NEUT水平均低于常规组(t=-1.819、2.124、5.166),治疗7 d后ESR、hs-CRP、IL-6、WBC及NEUT水平均低于常规组(t=4.747、2.626、3.675、3.242、3.254),差异均有统计学意义(P<0.05)。治疗后24 h,两组APACHEⅡ评分相比,差异无统计学意义(t=0.911,P>0.05)。治疗后72 h、7 d两组APACHEⅡ评分较24 h时显著降低,且观察组APACHEⅡ评分显著低于常规组,差异有统计学意义(t 72h=11.302,t 7d=14.134,P<0.05)。结论万古霉素骨水泥治疗肱骨外髁颈骨折术后髓内感染可有效抑制患者炎症反应,减少感染复发,促进病情好转。
Objective To investigate the effects of antibiotic bone cement on erythrocyte sedimentation rate(ESR)and serum inflammation in patients with intramedullary infection after external humeral neck fracture.Methods Totally 64 patients with intramedullary infection after external humeral neck fracture from July 2017 to July 2019 were selected.They were randomly divided into observation group and routine group,with 32 cases in each group.The routine group was treated with continuous irrigation with antibiotics,while the observation group was treated with antibiotic bone cement.ESR,hypersensitive C-reactive protein(hs-CRP),interleukin 6(IL-6),the number of white blood cells(WBC),neutrophil counts(NEUT)levels and acute physiology and chronic health evaluation systemⅡ(APACHEⅡ)score were compared between the two groups.Results 24 h after treatment,there were no statistically significant differences in ESR,hs-CRP,IL-6,WBC,NEUT levels between the two groups(t=-0.026,0.123,0.187,0.235,0.064,P>0.05).72 h after treatment,the levels of ESR,hs-CRP and NEUT in the two groups were significantly higher than those at 24h(routine group:t=-6.797,-4.948,-5.629;observation group:t=-3.453,-3.473,-2.081).The levels of ESR,hs-CRP and NEUT significantly decreased after 7d(routine group:t=3.097,5.831,2.564;observation group:t=12.859,7.178,5.746).There were statistically significant differences(P<0.05).72 h and 7 dafter treatment,the levels of IL-6 and WBC in the two groups were significantly lower than those after 24hours of treatment(72 h after treatment,routine group:t=2.396,1.768,observation group:t=2.696,2.045;7 d after treatment,routine group:t=6.334,3.006,observation group:t=8.756,4.703,P<0.05).The ESR,hs-CRP and NEUT levels in the observation group were lower than those in the routine group after 72h of treatment(t=-1.819,2.124,5.166).The ESR,hs-CRP,IL-6,WBC and NEUT levels in observation group were lower than those in the routine group after 7 d of treatment(t=4.747,2.626,3.675,3.242,3.254).The differences were statistically signi
作者
刘静文
纪福利
吕雪松
于海芳
LIU Jing-wen;JI Fu-li;LYU Xue-song;YU Hai-fang(Weichang County Hospital,Hebei 068450,China)
出处
《医学动物防制》
2021年第1期31-34,共4页
Journal of Medical Pest Control
基金
承德市科学技术研究与发展计划项目(201801A062)
关键词
肱骨外科颈骨折
抗生素骨水泥
髓内感染
应用价值
分析
External humeral neck fracture
Antibiotic bone cement
Intramedullary infection
Application value
Analysis
