腓肠神经皮瓣联合灌洗Ⅰ期治疗胫骨下段创伤性骨髓炎的临床研究

Clinical study of sural nerve flap combined with phase-Ⅰ lavage in the treatment of traumatic osteomyelitis in the lower segment of tibia

目的讨论在胫骨下端创伤性骨髓炎患者中使用腓肠神经皮瓣联合灌洗Ⅰ期的临床疗效,为提高骨髓炎患者的治疗效果提供依据。方法选取我院骨科2014年6月~2016年6月收治的胫骨下段创伤性骨髓炎32例患者作为研究对象,征求患者意见后,按入院顺序编号分组,每组各16例。实验组采用腓肠神经皮瓣联合灌洗Ⅰ期的治疗方式,对照组采用传统手术治疗方式,比较两组的手术时间、康复时间以及术后骨髓炎的复发情况。结果实验组平均手术时间短于对照组,差异有统计学意义(P<0.05)。实验组平均术后恢复时间长于对照组,差异有统计学意义(P<0.05)。对照组有3例复发骨髓炎,而实验组无复发情况,实验组的复发率低于对照组,差异有统计学意义(P<0.05)。结论使用腓肠神经皮瓣联合灌洗Ⅰ期的治疗模式,对胫骨下创伤性骨髓炎有着很好的治疗效果,有效的减低了骨髓炎术后复发的可能性,值得临床推广。

Objective To discuss the clinical efficacy of sural nerve flap combined with Phase-Ⅰlavage in treatment of the patients with traumatic osteomyelitis in the lower segment of tibia,so as to provide a basis for improving the treatment effect of osteomyelitis.Methods Altogether 32 patients with traumatic osteomyelitis in the lower segment of tibia who were treated in the department of orthopedics of our hospital from June 2014 to June 2016 were selected as the subjects of this research.After acquisition of the patients′informed consent,the patients were divided into two groups according to the order of admission,16 cases in each group.The experiment group was treated with combination of sural nerve flap and Phase-Ⅰlavage;while,the control group was treated with traditional surgical treatment methods.Patients′duration of surgery,recovery time and postoperative recurrence of osteomyelitis were compared between two groups.Results The average duration of surgery of the experiment group was shorter than that of the control group,with statistically significant difference(P<0.05);the average postoperative rehabilitation of the experiment group was longer that of the control group,with statistically significant difference(P<0.05).In the control group,3 cases had recurrent osteomyelitis,but the experiment group had no recurrence.The recurrence rate of the experiment group was lower than that of the control group.The two groups had statistically significant difference in the recurrence rate(P<0.05).Conclusion The application of combination of sural nerve flap and Phase-Ⅰlavage has a good therapeutic effect in treatment of the patients with traumatic osteomyelitis in the lower segment of tibia,which effectively reduces the possibility of postoperative recurrence of osteomyelitis and is worthy of clinical application.