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不同外科治疗方案在胫骨慢性骨髓炎症感染及软组织缺损患者的疗效对比 被引量:6

Therapeutic effects of surgical treatment programs on patients with chronic tibial osteomyelitis infection and soft tissue defects
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摘要 目的探讨不同外科治疗方案在胫骨慢性骨髓炎症感染和软组织缺损患者中的疗效。方法选取2006年1月-2015年10月在医院住院治疗的胫骨慢性骨髓炎症感染和软组织缺损的患者86例,将患者随机分为传统治疗组和联合治疗组,每组43例,传统治疗组患者给予传统外科治疗,联合治疗组给予负压封闭引流联合腓肠肌皮瓣治疗方案,比较两组患者的治疗效果,治疗前后C-反应蛋白含量变化,随访12个月后复发率,统计治疗前后两组患者的病原菌分布。结果联合治疗组治愈率显著高于传统治疗组,联合治疗组治愈时间显著低于传统治疗组,治疗后72h,联合治疗组患者C-反应蛋白含量显著低于传统治疗组,差异具有统计学意义(P<0.05);随访12个月后,联合治疗组骨髓炎复发率和继发感染率显著低于传统治疗组,差异具有统计学意义;治疗后,联合治疗组继发感染1例,传统治疗组继发感染13例。结论负压封闭引流联合腓肠肌皮瓣治疗方案应用于慢性骨髓炎症感染和软组织缺损患者的治疗可以提升治愈率,缩短治愈时间、降低炎症反应、复发率和继发感染率。 OBJECTIVE To explore the therapeutic effects of different surgical treatment programs on patients with chronic tibial osteomyelitis infection and soft tissue defects.METHODS A total of 86 patients with chronic tibial osteomyelitis infection and soft tissue defects who were hospitalized for treatment from Jan 2006 to Oct 2015 were enrolled in the study and randomly divided into the traditional treatment group and the combined treatment group,with 43 cases in each group.The traditional treatment group was given conventional surgical treatment programs,while the combined treatment group was given vacuum sealing drainage combined with gastrocnemius flap.The therapeutic effects were compared between the two groups of patients,the change of C-reactive protein level was observed before and after the treatment,the recurrence rate was analyzed after a 12-month follow-up,and the distribution of pathogens of the two groups of patients was statistically analyzed before and after the treatment.RESULTS The cure rate of the combined treatment group was significantly higher than that of the traditional treatment group,the cure time of the combined treatment group was significantly shorter than that of the traditional treatment group,the C-reactive protein level of the combined treatment group was significantly lower than that of the traditional treatment group after the treatment for 72hours(P〈0.05).The recurrence rate of osteomyelitis and incidence rate of secondary infection were remarkably lower in the combined treatment group than in the traditional treatment group after the 12-month follow-up there was 1case of secondary infection in the combined treatment group and 13 cases of secondary infection in the traditional treatment group after the treatment.CONCLUSIONThe vacuum sealing drainage combined with gastrocnemius flap may raise the cure rate of the patients with chronic tibial osteomyelitis infection and soft tissue defects,shorten the cure time,and reduce the incidence rates of inflammatory reactions,recurrence rate,and secondary infection.
出处 《中华医院感染学杂志》 CAS CSCD 北大核心 2017年第13期3036-3039,共4页 Chinese Journal of Nosocomiology
关键词 负压封闭引流 胫骨慢性骨髓炎症 感染 软组织缺损 Vacuum sealing drainage Chronic tibial osteomyelitis Infection Soft tissue defect
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