负压封闭引流术治疗慢性化脓性骨髓炎的临床研究

Investigation on clinical effect of vacuum sealing drainage for pyogenic osteomyelitis

目的探讨负压封闭引流术治疗慢性化脓性骨髓炎的临床疗效。方法选取2009年9月至2011年9月我院纳入38例慢性化脓性骨髓炎患者,将所有患者随机分为治疗组与对照组各19例,治疗组采用负压封闭引流,对照组采用传统闭式灌洗引流。结果对照组术后随访9～37个月平均(29.4±4.1)个月,4例发生创面感染,其中2例合并引流管堵塞,经再次手术放置新的引流管同时进行抗感染等治疗后愈合;治疗组术后随访6～24个月,平均(18.5±7.2)个月,2例患者发生创面感染,行病骨截除加压延长术后愈合良好,其余均愈合。两组复发率、愈合时间差异有统计学意义(P<0.01)。结论负压冲洗可以有效清除术后病灶内渗出物,起到清创的作用,同时防止冲洗过程中大量坏死组织对引流管造成的堵塞,减少感染复发,提高患者治愈率。

Objective To investigate the clinical effect of vacuum sealing drainage(VSD) for pyogenic osteomyelitis.Methods 38 cases who were suffered from chronic pyogenic osteomyelitis in our hospital from sep 2009 to sep 2011 were randomly divided into two groups after debridement of which study group were given VSD whereas another 19 patients were given closed continuous douche(CCD).therapy.Results There were significant difference in rate of recurrence between two groups.The VSD group were followed up for 18.2 months on average with 10.5% rate of recurrence,while CCD was 26.3% followed up for 29.4 months on average.Conclusion VSD can be of great effects in preventing complication rate after debridement for patients suffered from chronic pyogenic osteomyelitis.