庆大霉素缓释珠链在开放性骨折治疗中的应用

Application of gentamicin-PMMA bead chain in treatment of open fractures

目的探讨庆大霉素缓释珠链在开放性骨折治疗中的应用。方法开放性骨折795例治疗分两组:对照组426例仅接受全身抗生素的运用,其余369例加用了庆大霉素缓释珠链来增强局部抗感染作用。结果对照组急性感染和深部骨组织感染率为14%(60/426),而珠链组为4.1%(15/369)。两组结果有显著性差异。使用庆大霉素缓释珠链后各骨折类型的感染率均有明显的下降,但Ⅲ型开放性骨折的显著性最大。结论庆大霉素缓释珠链在开放性骨折的治疗中,其治愈成功率高、并发症发生率低,具有显著的优越性。

Objective To discuss the use of gentamicin PMMA bead chain in treatment of open fractures. Methods 795 consecutive open fractures were treated in our department. These patients were divided into 2 groups. 426 received only systemic antibiotic prophylaxis (the contrast group), while 369 cases were managed with systemic antibiotics and adjuvant application of gentamicin PMMA beads to prevent local infection. Results The overall infection rate of acute infection and /or chronic osteomyelitis was 14%in the contrast group(60/426)but 4.1%in the beads group(15/369). The difference was highly significant. The use of beads reduced the incidence of infection in all types of the fracture, and most significantly in type Ⅲfractures. Conclusion Use of gentamicin PMMA bead chain as an adjuvant to conventional intravenous antibiotics is more effective in treatment of open fractures.