去甲万古霉素链珠个体化治疗耐甲氧西林葡萄球菌感染的慢性骨髓炎的研究

Study on Individual Norvancomycin Chain Bead Regimen in the Treatment of Methicillin-resistance Staphylococcus Infection Chronic Osteomyelitis

目的:探索治疗耐甲氧西林葡萄球菌(MRS)感染的慢性骨髓炎的新途径。方法:选择确诊为MRS感染的慢性骨髓炎患者27例,将其随机分为2组,术前均静脉滴注去甲万古霉素防止感染,试验组(15例)以去甲万古霉素链珠(去甲万古霉素与骨水泥混合物)填充缺损处;对照组(12例)仅以骨水泥填充缺损处。比较2组感染治愈率、治愈感染所需抗生素治疗成本、不良反应发生率、治愈所需时间。结果:2组治疗MRS感染的慢性骨髓炎皆有效,但试验组不良反应发生率和抗生素治疗成本较低,同时控制感染也较快。结论:采用去甲万古霉素链珠个体化治疗MRS感染的慢性骨髓炎优于仅静脉给予去甲万古霉素的治疗方法。

OBJECTIVE：To explore new therapy regimen for methicillin-resistance staphylococcus infection chronic osteomyelitis. METHODS：27 patients with methicillin-resistance staphylococcus infection chronic osteomyelitis were randomly divides into 2 groups. Both groups were injected with norvancomycin intravenously before operation to prevent infection. Norvancomycin chain bead （NCB） which were made from norvancomycin and bone cement was used to make up bone defect in NCB group（15 patients）. Bone cement was used to make up bone defect in norvancomycin group（12 patients）. The cure rates, the cost of infection therapy, the incidence of ADR and therapy duration were compared between 2 groups. RESULTS： Both NCB and intravenous administration of norvancomycin had sound effect on chronic osteomyelitis. The incidence of ADR and the cost of infection therapy of NCB regimen were close to low level. The infection was controlled effectively. CONCLUSION：Individual NCB regimen is superior to intravenous administration of norvancomycin in the treatment of methicillin-resistance staphylococcus infection chronic osteomyelitis.