抗生素骨水泥覆盖治疗感染性创面的疗效观察

The curative effect of antibiotic bone cement in the treatment of infectious wounds

目的探讨抗生素骨水泥覆盖治疗感染性创面的方法和临床效果。方法回顾性分析2017年11月—2019年3月惠州市中医医院骨科收治的26例感染性创面患者,男性15例,女性11例;年龄8~77岁,平均46.2岁。其中创伤后感染15例,手术后切口感染6例,糖尿病足5例。给予彻底清创、抗生素骨水泥覆盖、抗感染治疗,观察临床疗效和创面愈合时间。结果所有患者感染性创面肉芽生长良好,创面逐渐缩小至愈合,或经植皮后痊愈,愈合时间平均(14.9 6.2)d。愈合时间<14d、14~28d、>28d的占比分别为73%(19/26)、23%(6/26)、4%(1/26);住院时间平均(13.7±8.0)d,治疗前白细胞计数(WBC)、降钙素原(PCT)、红细胞沉降率(ESR)、C反应蛋白(CRP)分别为(12.04±1.37)×109/L、(0.23±0.10)ng/L、(63.08±23.11)mm/h、(46.88±20.90)mg/L,治疗后分别为(7.21±1.03)×109/L、(0.04±0.02)ng/L、(23.04±8.24)mm/h、(10.47±4.61)mg/L,前后比较P均<0.05。所有痊愈患者经随访6个月以上,均无复发。结论抗生素骨水泥覆盖术治疗感染性创面能有效控制感染,简便效廉,值得临床推广。

Objective To investigate the method and clinical efficacy of antibiotic bone cement in the treatment of infectious wounds.Methods From Nov. 2017 to Mar. 2019,26 patients with infectious wounds were treated,including 15 males and 11 females,with an average of 46.2(8-77)years old.In all cases,15 cases were infected after trauma,6 cases were infected by incision after operation,and 5 cases were diabetic foot infection.Thorough debridement,antibiotic bone cement coverage and anti-infective treatment were given,and the clinical curative effect and wound healing time were observed.Results The granulation tissue of infected wounds grew well for all patients,the wounds gradually reduced to healing,or healed after skin grafting.The average healing time was(14.9±6.2)days.The healing time of less than 14 days,14 to 28 days,more than 28 days accouted for 73%(19/26),23%(6/26),4%(1/26),respectively.The average hospitalization time was(13.7±8.0) days.The WBC,PCT,ESR and CRP before treatment were(12.04±1.37) ×109/L,(0.23±0.10) ng/L,(63.08±23.11) mm/h,(46.88±20.90)mg/L,respectively.After treatment,the index were(7.21±1.03)×109/L,(0.04±0.02) ng/L,(23.04±8.24) mm/h,and(10.47±4.61) mg/L,and the P values were less than 0.05 before and after treatment. All recovered patients were followed up for more than 6 months without recurrence.Conclusion Antibiotic bone cement in the treatment of infectious wounds can effectively control infection,which is simple and safe,and worth promoting clinically.