封闭负压引流联合万古霉素对慢性骨髓炎创面不愈合及软组织缺损患者CRP、TNE-α、IL-6水平的影响

Impact of vacuum sealing drainage plus vancomycin in serum CRP,TNF-α, and IL-6 concentrations for chronic osteomyelitis patients with unhealed wound and soft tissue defects

目的研究封闭负压引流+万古霉素运用于慢性骨髓炎创面不愈合及软组织缺损中的价值。方法选择该院2015年1月至2017年12月纳入的60例慢性骨髓炎创面不愈合及软组织缺损患者,按照数字表法随机分为两组各30例,研究组采取封闭负压引流+万古霉素,对照组采取常规治疗,对比两组治疗结果及血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平。结果研究组骨吸收、骨缺损愈合时间短于对照组(P<0.05);治疗前两组VAS评分差异无统计学意义(P>0.05),治疗后研究组评分低于对照组(P<0.05)。治疗前两组的CRP、TNF-α、IL-6水平差异无统计学意义(P>0.05),治疗后研究组各指标水平均低于对照组(P<0.05)。两组1个月、3个月复发率差异无统计学意义(P>0.05),研究组6个月、1年的复发率低于对照组(P<0.05)。结论封闭负压引流+万古霉素运用于慢性骨髓炎创面不愈合及软组织缺损中效果明显,可缩短治疗时间,促进骨缺损愈合,改善炎症反应,减少复发率,为预后提供保障。

【Objective】To study the value of vacuum sealing drainage(VSD)plus vancomycin in the serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)concentrations for chronic osteomyelitis patients with unhealed wound and soft tissue defects.【Methods】Sixty chronic osteomyelitis patients with unhealed wound and soft tissue defects treated from January 2015 to December 2017 in our hospital were selected and randomly assigned to two groups,30 cases in each group.The research group took VSD and vancomycin;the control group took the conventional therapy.The serum CRP,TNF-αand IL-6 concentrations were compared.【Results】The time of bone absorption and bone healing in the research group was shorter than that in the control group(P<0.05);before treatment,Visual Analogue Scale(VAS)scores between groups were not significantly different(P>0.05);after treatment,VAS scores in the research group were lower than those in the control group(P<0.05);before treatment,serum CRP,TNF-αand IL-6 concentrations between groups were not significantly different(P>0.05);after treatment,related values in the research group were lower than those in the control group(P<0.05);within 1 month and 3 months,recurrence rate between groups was not significantly different(P>0.05);after 6 months and 1 year,recurrence rate in the research group was lower than that in the control group(P<0.05).【Conclusion】The combination of VSD and vancomycin can shorten the treatment time,promote the bone healing,reduce the inflammatory response and recurrence rate,and improve patient’s prognosis.