碘附灌洗治疗慢性骨髓炎的效果

EFFECT OF IODOPHOR DOUCHE ON CHRONIC OSTEOMYELITIS

①目的 探讨碘附灌洗治疗慢性骨髓炎的效果。②方法 对 2 4例慢性骨髓炎病人行病灶清除术 ,术后随机分为两组 (各 12例 ) ,碘附组应用碘附溶液与生理盐水交替进行缓慢灌洗 ,当碘附灌洗的总时间达 2 0h后单用生理盐水冲洗 ;抗生素组根据细菌培养和药物敏感试验结果选用抗生素溶液冲洗。体温正常、局部无炎症表现、引流液清晰透明时拔管停止冲洗。③结果 碘附组冲洗时间为 5～ 9d ,平均 (6 .9± 1.2 )d ,近期效果良好 ,随访10个月～ 4年 ,无一例复发 ,未出现碘附的近、远期明显毒性反应和副作用 ;抗生素组冲洗时间为 16～ 30d ,平均(2 4 .5± 3.2 )d ,近期效果良好 ,但随访 10个月～ 4年 ,有 4例复发。④结论 碘附灌洗治疗慢性骨髓炎无明显毒性反应和副作用 ,具有疗效迅速、确切。

Objective To evaluate the effect of iodophor douche therapy on chronic osteomyelitis. Methods A focal cleaning was done for 24 patients with chronic osteomyelitis, who were then randomly divided into two groups (12 patients in each group). In iodophor group, a slow irrigation with iodophor solution and normal saline was applied alternately, and when the total irrigation time of iodophor reached 20 hours, only normal saline was used. In antibiotics group, irrigation with antibiotic, based on the results of bacteria culture and drug sensitivity, was carried out. The douche was terminated and the drainage-tube pulled out when the drainage liquid was transparent, body temperature normal and local inflammation disappeared. Results The follow-up was from 10 months to four years for both groups. The irrigation time for iodophor group was 5-9 (6.9±1.2) days. No relapse, or toxic or side effects of iodophor were noted. In the antibiotic group, the irrigation was 16-30 (24.5±3.2) days, four cases relapsed during the period of follow-up. Conclusion The iodophor douche therapy for chronic osteomyelitis is effective without any obvious toxic or side effects, and no recurrence.