摘要
目的分析骨骺骨髓炎3种不同治疗方式对预后的影响。方法选取确诊为骨骺骨髓炎的患儿90例,根据治疗方式分为3组各30例,A组行关节切开冲洗引流+干骺端钻孔减张术,B组行单纯冲洗引流术,C组未行手术治疗。随访时每组剩21例,比较各组治疗前后肩关节活动度(8例)、髋关节活动度(7例)和膝关节活动度(6例)以及住院时间和拔管时间。结果治疗后6个月,A组和B组肩关节的外展、前屈和后伸活动度、C组外展和后伸活动度均较治疗前明显增加,A组和B组肩关节外展、前屈和后伸活动度均较C组增加,A组又均较B组增加(P<0.05)。治疗后6个月,3组髋关节屈曲、外展和内收活动度均较治疗前明显增加,A组和B组髋关节屈曲、外展活动度均较C组增加(P<0.05)。治疗后6个月,3组膝关节活动度均较治疗前明显增加(P<0.05),但3组间膝关节活动度差异无统计学意义(P>0.05)。A组和B组住院时间少于C组,A组又少于B组,A组拔管时间少于B组,差异均有统计学意义(P<0.05)。结论行切开引流+干骺端钻孔减张术对于恢复患者的肩关节(外展、前屈和后伸)活动度、髋关节(屈曲、外展和内收)活动度和膝关节屈伸活动度有较好的疗效,且住院时间和拔管时间短,可以降低该疾病的致残率,提高患儿术后生活质量。
Objective To analyze the effect of three different treatment methods on the prognosis of epiphyseal osteomyelitis.Methods Infans with epiphyseal osteomyelitis were selected and divided into three groups according to the treatment methods:group A underwent arthrotomy and drill,and group B underwent arthrotomy.Group C did not undergo surgery treatment group as a control group.At the time of follow-up,21 cases remained in each group.The shoulder joint activity(n=8),hip joint activity(n=7)and knee joint activity(n=6)as well as hospitalization and extubation time were compared before and after treatment.Results Six months after treatment,the range of shoulder joint abduction,flexion and extension in group A and group B,and the range of shoulder joint abduction and extension in group C were increased significantly compared with that before treatment(P<0.05).Six months after treatment,the range of shoulder joint abduction,flexion and extension in group A and group B were increased compared with that in group C,and the difference was statistically significant(P<0.05).Six months after treatment,the range of shoulder joint abduction,flexion and extension in group A was higher than that in group B(P<0.05).The flexion,abduction and adduction of the hip joint in group A and B were significantly higher than those in group C(P<0.05),and the flexion and abduction of the hip joint in group A and B were significantly higher than those in group C(P<0.05).After 6 months of treatment,the knee joint activity in three groups was significantly higher than that before treatment(P<0.05),but after 6 months of treatment,there was no statistical difference in knee joint activity among the three groups.Learning significance(P>0.05),the hospitalization time of group A and B was less than that of group C,group A was less than that of group B,and the extubation time of group A was less than that of group B,the difference was statistically significant(P<0.05).Conclusion Arthrotomy and drilling is effective in restoring shoulder joint(abduction,flexion and extension),hip joint(flexion,abduction and adduction)and knee joint flexion and extension,and shorter hospitalization and extubation time can reduce the disability rate of the disease and improve the quality of life of infan after operation.
作者
何明哲
孙一硕
张放
崔硬铁
甄磊
HE Ming-zhe;SUN Yi-shuo;ZHANG Fang;CUI Ying-tie;ZHEN Lei(The First Department of Orthpedics,Affiliated Hebei Children's Hospital ofHebei Medical University,Hebei Province,Shijiazhuang 050031,China)
出处
《河北医科大学学报》
CAS
2019年第5期533-537,共5页
Journal of Hebei Medical University
基金
河北省医学科学研究重点课题(20150570)
关键词
骨髓炎
骨骺
婴儿
osteomyelitis
epiphyses
infan