抗生素骨水泥物理和力学性能及洗提特性的实验研究

Physical and mechanical characteristic of bone cement mixed with antibiotics

目的探讨头孢类抗生素加入国产骨水泥后,对其物理和力学性能的影响,以及抗生素的析出情况,以期指导临床应用。方法分别在40g骨水泥中加入1g硫酸庆大霉素、2g硫酸庆大霉素、1g头孢拉啶、1.5g头孢呋辛、1g头孢三嗪。分别测定骨水泥的面团时间、挤嵌值、压缩强度、弯曲模量和弯曲强度,并进行洗提试验。结果40g骨水泥中加入1～1.5g的抗生素不会对骨水泥的物理和力学性能产生影响;当庆大霉素剂量达到2g时,其力学性能将发生改变。头孢拉啶的洗提总量明显高于其他各组(P<0.01),而且洗提时间最长。结论抗生素能有效地从骨水泥中持续释放;40g国产骨水泥中加入1～1.5g抗生素不会影响骨水泥的物理和力学性能;在抗生素种类的选择方面,可以将头孢拉啶作为首选抗生素,而且全身应用的抗生素最好与骨水泥中应用的抗生素相一致。

Objective To investigate the physical and mechanical properties of home-made bone cement mixed with different antibiotics.Methods The specimens of bone cement each of 40g were divid-ed in to6groups depending on mixed antibiotics,groupⅠmixed with1g gentamicin,groupⅡwith2g gen tam icin,groupⅢwith1g cephradine,groupⅣwith1.5g cefuroxine,groupⅤwith1g ceftriaxone and groupⅥwith out any antibiotics served as control.The dough time,compressing depth,compressive strength,bending strength and bending elastic modulus were measured respectively,elution examination of antibiotics from bone ce ment was performed by chromatography.Results The dough time and compress-ing depth of the groups were better than that of ISO5833standard,and there was no significant difference a-mong the groups.The com pressive strength and bending strength of the groupⅡwere lower than that ISO5833standard,but there was no significant difference among the groups by analysis of variance.The bending elastic modulus of the groupⅡwas lower than the control group and other groups(P<0.05).The elution rate of 4antibiotics decreased exponentially.The release of gentamycin from bone cement lasted only about 2weeks,at5weeks later,the releasing rate of cephradin and cefuroxime were(0.08±0.01)μg and(0.02±0.00)μg respectively.The total amount of cephradine released from bone cement was highest among six groups(P<0.01),and its elu tion time was also longer than other antibiotics(P<0.01).Conclusion Antibi otics can be released from bone ce ment.There is no influence on the physical and mechanical properties of do mestic bone cement mixed with proper dose of antibiotics.Cephradine is an ideal antibiotic used in addi tion to bone cement for preven tion and treatment of postoperative infection of THA.