三联疗法治疗慢性骨髓炎及深部软组织感染的临床疗效分析

Clinical efficacy of triple therapy on chronic osteomyelitis and deep soft tissue infection

目的:研究三联疗法治疗慢性骨髓炎及深部软组织感染的临床疗效。方法:选择2015年7月-2017年9月我院收治慢性骨髓炎及深部软组织感染患者15例,根据患者入院顺序,分别标记为奇数组及偶数组。奇数组为治疗组,持续静滴敏感抗生素、负压封闭引流技术(Vacuum Sealing Drainage,VSD)技术结合间隔敏感抗生素灌注、口服五味消毒饮加味;偶数组为对照组:静滴敏感抗生素及VSD持续负压引流方法。根据创口分泌物培养及药敏结果,两组患者均选用敏感抗生素抗炎治疗一周后行手术治疗,术后继续静滴敏感抗生素3周后改用口服抗生素2周。以随访12个月为研究终点,监测体温,白细胞、血沉、C反应蛋白,创口分泌物培养、影像学情况及感染复发情况。结果:两组患者术后体温、白细胞、C反应蛋白及血沉较术前均有明显好转,治疗组相对于对照组在术后第14 d体温,术后第7 d白细胞情况无明显差异,但在其余指标上均有明显优势。结论:三联疗法能够显著控制及治疗骨及深部软组织慢性感染,降低复发几率,减轻治疗费用缩短及住院周期,疗效满意。

Objective:To study the clinical efficacy of triple therapy on chronic osteomyelitis plus deep soft tissue infection.Methods:15 patients were enrolled in our hospital from July 2015 to September 2017.According to the order of admission,they were labeled as odd arrays(the treatment group)and even arrays(the control group).The treatment group took sensitive antibiotics,VSD with Wuwei Xiaodu Yin(五味消毒饮).The control group was given sensitive antibiotics plus VSD.According to the results of wound secretion culture and drug susceptibility,two groups were treated with sensitive antibiotics for anti-inflammatory,for one week,and then treated by surgery.After continuous intravenous infusion of sensitive antibiotics for 3 weeks,oral antibiotics were applied for 2 weeks.Results:The postoperative body temperature,white blood cells,C-reactive protein and erythrocyte sedimentation rate were significantly improved in two groups.There was no difference in body temperature at the 14 th day after surgery and white blood cell status at the 7 th day after surgery between two groups.There are obvious advantages in the remaining indicators.Conclusion:Triple therapy can significantly control and treat chronic infections of bone and deep soft tissues,reduce recurrence and the cost of treatment and shorten the hospitalization,with good effects.