万古霉素骨水泥填充联合负压封闭引流治疗对慢性骨髓炎患者血清肿瘤坏死因子水平的影响

Effect of vancomycin bone cement filling combined with vacuum sealing drainage on serum tumor necrosis factor levels in patients with chronic osteomyelitis

目的 探讨万古霉素骨水泥填充联合负压封闭引流治疗对慢性骨髓炎患者血清肿瘤坏死因子水平的影响。方法 收集2018年10月至2020年6月本院接收的46例慢性骨髓炎患者,根据随机数字表法将其分为两组,对照组23例予万古霉素骨水泥填充治疗,观察组23例予万古霉素骨水泥填充联合负压封闭引流治疗,比较两组炎症因子、临床疗效及病情恢复情况。结果 观察组治疗后血清肿瘤坏死因子α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素6(Interleukin-6,IL-6)及白细胞介素17(Interleukin-17,IL-17)水平比对照组低(P<0.05);观察组创面感染控制率、治疗后2周无菌率均比对照组高,且观察组总有效率为95.65%,比对照组的73.91%高(P<0.05);观察组冲洗、细菌培养转阴、伤口愈合及住院时间均比对照组短(P<0.05)。结论 万古霉素骨水泥填充联合负压封闭引流应用于慢性骨髓炎治疗中可有效降低患者TNF-α、IL-6、IL-17水平,且有助于提升疗效,促进患者病情恢复。

Objective To investigate the effect of vancomycin cement filling combined with vacuum sealing drainage on serum tumor necrosis factor levels in patients with chronic osteomyelitis.Methods A total of 46 patients with chronic osteomyelitis in our hospital from October 2018 to June 2020 were selected and divided into the control group(n=23)and the observation group(n=23).The control group was treated with vancomycin bone cement filling.The observation group was treated with vancomycin bone cement filling and vacuum sealing drainage according to random number table.Inflammatory factors,clinical efficacy and disease recovery were compared between the two groups.Results After treatment,the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-17(IL-17)in the observation group were lower than those in the control group(P<0.05).The wound infection control rate and sterility rate 2 weeks after treatment in the observation group were higher than those in the control group.The total effective rate of the observation group was 95.65%,higher than 73.91%in the control group(P<0.05).The time of irrigation,bacterial culture negative situation,wound healing and hospitalization in the observation group was shorter than that in the control group(P<0.05).Conclusion Vancomycin bone cement filling combined with vacuum sealing drainage in the treatment of chronic osteomyelitis can effectively reduce the levels of TNF-α,IL-6 and IL-17,and help to improve the efficacy and promote the recovery of patients.