两种方法治疗慢性骨髓炎合并骨缺损的疗效比较

Comparison of effects of two methods in treatment of chronic osteomyelitis with bone defect

目的探讨万古霉素骨水泥链填塞和Ilizarov牵拉成骨治疗慢性骨髓炎合并骨缺损的临床效果。方法选取收治的骨髓炎合并骨缺损患者63例,其中采用万古霉素骨水泥链填塞治疗26例(A组),采用Ilizarov牵拉成骨术治疗37例(B组),对两组临床治疗效果进行比较。结果两组治愈率、并发症发生率以及愈合时间无统计学差异(P>0.05),A组平均手术次数多于B组,而住院天数、住院花费均低于B组(P<0.05)。A组平均骨痂愈合分级在不同时间段(术前、术后12月除外)均高于B组(P<0.05)。炎症指标计分随术后时间递减,且存在统计学差异(P<0.05)。结论在治疗慢性骨髓炎合并骨缺损时,万古霉素骨水泥链填塞与Ilizarov牵拉成骨术各具优缺点,需根据患者骨缺损范围及患者个体情况制定合适的手术方案。

Objective To explore the clinical effects of vancomycin bone cement chain packing and Ilizarov distractionosteogenesis in the treatment of chronic osteomyelitis with bone defects. Metfiods A total of 63 cases of osteomyelitis and bone defect patients from February 2010 to September 2015 in our department were selected. Group A （n=26）received vancomycin bone cement chain packing treatment,group B （n =37） received Ilizarov distraction osteogenesis surgery treatment. The treatment effects were compared bet^ween t＂wo groups. Results The cure rate, complication rate and healing time had no significant differences between two groups （P〉 0.05）. The average number of operations of group A was more than that of group B,but the number of inpatient hospital days and cost were less than those of group B （P 〈 0.05）. Group A had a higher average healing callus classification in different periods than group B （P 〈 0.05）. The inflammation index score decreased gradually after operation in both groups （P 〈 0.05）. Conclusions In the treatment of chronic osteomyelitis and bone defect, either vancomycin bone cement chain packing and Ilizarov distraction osteogenesis surgery has its own advantages or disadvantages, an appropriate surgical schema should be made based on the bone defect area and the individual conditions of the patient.