骨水泥联合Ilizarov技术对胫骨慢性骨髓炎患者患肢功能及伤口细菌含量的影响

Influences of Bone Cement Combined with IlizarovTechnology on DiseasedLimb Function and Bacterial Content of Wound in Patients with Tibia Chronic Osteomyelitis

目的:探讨骨水泥联合Ilizarov技术对慢性骨髓炎患者患肢功能及伤口细菌含量的影响。方法:将2015年1月至2018年2月我院收治的胫骨慢性骨髓炎患者62例,随机分为对照组(n=31,给予Ilizarov骨搬移技术治疗)和观察组(n=31,在对照组基础上采取抗生素骨水泥链珠植入治疗)。对比两组换药次数、使用抗生素时间、创面愈合时间、住院时间等指标、患肢功能恢复情况、关节功能恢复情况、细菌检出率以及生活质量。结果:观察组换药次数、使用抗生素时间、创面愈合时间、住院时间均较对照组少,有统计学意义(P<0.05);观察组患肢功能恢复优良率较对照组显著增高,有统计学差异(93.55%vs 74.19%P <0.05);两组治疗后膝关节美国纽约特种外科医院评分(HSS)、踝关节功能评分(Baird-Jackson)均高于治疗前,且观察组均高于对照组,有统计学差异(P <0.05);观察组细菌检出率较对照组显著降低,有统计学差异(6.45%vs 32.26%P<0.05);两组治疗后世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分高于治疗前,且观察组高于对照组,有显著性差异(P<0.05)。结论:骨水泥联合Ilizarov技术治疗慢性骨髓炎不仅能促进患肢功能恢复,减少致病菌,同时可有效改善患者生活质量。

Objective: To investigate the influences of bone cement combined with Ilizarovtechnology on the diseasedlimb function and bacterial content of wound in patients with chronic osteomyelitis. Methods: 62 cases of patients with chronic osteomyelitis of tibia from January 2015 to February 2018 were randomly divided into two groups, 31 patients in the control group were treated with Ilizarov bone graft technology, and 31 patients in the observation group were treated with antibiotic bone cement chain bead implantation on the basis of the control group.The times of dressing change, the time of using antibiotics, the time of wound healing and the length of stay, the diseasedlimb functional recovery, the recovery of joint function, the detection rate of bacteria and the quality of life were compared. Results: The times of dressing change, the time of using antibiotics, the time of wound healing and the length of stay in the observation group were less than those in the control group (P<0.05);the excellent and good rate of diseased limbfunctional recovery in the observation group was 93.55%, which was higher than 74.19%in the control group (P<0.05);after treatment, the two groups of knee joint score of New York Special Surgery Hospital (HSS) and ankle joint function score (Baird-Jackson) were higher than those before treatment (P<0.05), and the observation group was higher than that of the control group (P<0.05);the detection rate of bacteria in the observation group was 6.45%, which was lower than 32.26% in the control group (P<0.05);after the treatment of the two groups, the score of the quality of life of WHO (WHOQOL-BREF) was higher than that before the treatment (P<0.05), and the observation group was higher than that of the control group (P<0.05). Conclusion: Bone cement combined with Ilizarov technology in treating chronic osteomyelitis can not only promote the recovery of diseased limb function, reduce pathogenic bacteria, but also effectively improve the quality of life of patients.