创伤性胫骨骨髓炎应用抗生素骨水泥治疗的临床疗效观察

Antibiotic bone cement for traumatic tibial osteomyelitis

目的探讨创伤性胫骨骨髓炎应用抗生素骨水泥治疗的临床疗效。方法收集2015年4月至2016年4月入院的100例创伤性胫骨骨髓炎患者，随机分为两组，对照组患者给予抗生素局部灌注，实验组患者则给予抗生素骨水泥治疗，比较两组患者疾病相关临床参数、总体治疗效果、抗感染指标、疼痛与功能水平。结果实验组患者细菌培养转阴时间为（14．06±2．11）d、创面愈合时间为（26．33±4．75）d、换药次数为（5．71±0．96）次与住院时间为（29．30±4．14）d，均显著低于对照组f（17．13±2．32）d，（30．70±4．09）d，（7．66±1．12）次，（33．74±4．51）dl术后4周WBC计数为（8．71±0．68）×109，Hs—CRP水平为（2，03±0．54）mg／L，组间比较均显著低于对照组[（9．77±0．80）×109，（3．27±0．63hg／L1末次随访VAS评分为（1．54±0．24）分，组间比较显著低于对照组的（1．94±0．31）分，HHS评分为（89．81±7．48）分与Baird—Jackson评分为（84．54±6．92）分，组问比较均显著高于对照组[（72．35±7．50）分，（71．09±6．74）分1，差异均有显著统计学意义（均P〈0．01）；创面感染控制率（100％）与总有效率（100％）明显高于对照组（90％，88％），复发率（6％）明显低于对照组（12％），差异有统计学意义（P〈0．05）。结论创伤性胫骨骨髓炎应用抗生素骨水泥治疗的临床疗效显著，具有借鉴意义。

Objective To investigate the clinical efficacy of antibiotic bone cement for traumatic tibial osteomyelitis. Methods 100 patients with traumatic tibial osteomyelitis admitted into our hospital from April, 2015 to April, 2016 were randomly divided into a control group and an experimental group. The control group were treated with local antibiotics. The experimental group were treated with antibiotic bone cement. The disease-related clinical parameters, overall therapeutic effect, anti-infective index, pain, and functional level were compared between these two groups. Results The time for bacterial culture turning to negative, wound healing time, dressing-changed times, and hospital stay were （14.06±2.11）d, （26.33±4.75）d, （5.71±0.96）, and （29.30±4.14）d in the experimental group and were （17.13±2.32） d, （30.70±4.09）d, （7.66±1.12）, and （33.74±4.51）d in the control group. Four weeks after the operation, the WBC and Hs-CRP level were （8.71±0.68）×109 and （2.03±0.54）mg/L in the experimental and were （9.77±0.80）×109 and （3.27±0.63）mg/L in the control group. The VAS score at the last follow-up was lower and the scores of HHS and Baird-Jackson were higher in the experimental group than in the control group [（1.54±0.24） vs. （1.94±0.31）, （89.81±7.48） vs. （72.35±7.50）, and （84.54±6.92） vs. （71.09±6.74）], with statistical differences （all P〈0.01）. The controlled rate of wound infection and the total effective rate were significantly higher and the recurrence rate was significantly lower in the experimental group than in the control group （100% vs. 90%, 100% vs. 88%, and 6% vs. 12%）, with statistical differences （all P〈0.05）. Conclusion The clinical effect of antibiotic bone cement for traumatic tibial osteomyelitis is significant and has reference significance.