摘要
目的:比较不同时期植骨治疗开放性骨折术后继发Ⅲ、Ⅳ型骨髓炎的疗效。方法:选取2013年6月至2017年6月广西玉林市中西医结合骨科医院收治的90例继发Ⅲ型、Ⅳ型骨髓炎患者,按随机数字表法分为一期组与二期组,每组45例。一期组采取骨髓炎病灶清除术后1. 5~2个月植骨治疗,二期组采取骨髓炎病灶清除术后3~6个月植骨治疗。比较两组治愈率、复发时间、骨愈合时间、感染指标[血常规、血沉(ESR)、C反应蛋白(CRP)]、治疗前和末次随访的生活质量。结果:两组治愈率、复发时间及生活质量比较,差异均无统计学意义(均P>0. 05)。两组植骨后ESR水平较植骨前降低,CRP水平均较植骨前升高(P<0. 05),末次随访生活质量各维度评分均显著高于治疗前(均P<0. 05),但组间比较均无明显差异(P>0. 05)。一期组骨愈合时间显著短于二期组(P<0. 05)。结论:骨髓炎病灶清除术后1. 5~2个月植骨与术后3~6个月植骨对开放性骨折术后继发Ⅲ型、Ⅳ型骨髓炎患者的治愈率相当,患者远期生活质量相当,但前者可缩短骨折愈合时间,减少术后感染机会,更具优势。
Objective: To compare the efficacy of bone graft treatment in different periods for the treatment of type Ⅲ and Ⅳ osteomyelitis after open fracture. Methods: A total of 90 patients with secondary osteomyelitis admitted to our hospital from June2013 to June 2017 were randomly divided into first-stage group and second-stage group,with 45 cases in each group. The first-stage group patients were treated with bone marrow inflammation on 1. 5-2 months after the removal of osteomyelitis lesions. The second-stage group patients were treated with bone grafting on 3-6 months after removal of osteomyelitis lesions. The cure rate,recurrence time,bone healing time,infection indexes[blood routine,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)],and the quality of life were compared between two groups. Results: There was no significant difference in cure rate,recurrence time and quality of life between the two groups(P>0. 05). The ESR decreased while CRP increased in both groups after bone grafting(P<0. 05). The life quality scores in all dimensions during the last follow-up were significantly higher than those before treatment(P<0. 05),but no significant difference was found between the two groups(P>0. 05). Bone healing time in the first stage group was significantly shorter than that in the second stage group(P<0. 05). Conclusion: 1. 5-2 months and 3-6 months of bone grafting after removal of osteomyelitis lesions can achieve similar cure rate and long-term life quality in patients with secondary Ⅲ or Ⅳ osteomyelitis after open fractures surgery,but the former can shorten fracture healing time and reduce postoperative infection.
作者
李华
谢卫宁
Li Hua;Xie Weining(Department of Osteopathy,Integrated Traditional Chinese and Western Medicine Orthopedic Hospital,Yulin 537000,China)
出处
《广西医科大学学报》
CAS
2019年第10期1655-1659,共5页
Journal of Guangxi Medical University
基金
广西玉林市科学研究与技术开发计划课题资助项目(No.玉市科攻20173050)
关键词
继发骨髓炎
植骨
开放性骨折
骨愈合
secondary osteomyelitis
bone grafting
open fracture
bone healing
