万古霉素氢氧化钙骨水泥治疗下肢长骨慢性骨髓炎的临床疗效

Clinical effects of vancomycin calcium hydroxide bone cement on chronic osteomyelitis of lower extremity

目的观察万古霉素氢氧化钙骨水泥治疗下肢长骨慢性骨髓炎的临床疗效。方法选取下肢长骨慢性骨髓炎患者70例,随机分为对照组(植入万古霉素硫酸钙骨水泥)及观察组(植入万古霉素氢氧化钙骨水泥)。比较两组术前细菌检查及耐药性;比较两组感染指标、切口愈合时间、术后下地时间、住院时间、术后12周X线情况,以及手术前后视觉模拟评分(VAS)、抑郁评估量表(PHQ-9)及焦虑障碍量表(GAD-7)评分。结果两组细菌检查及耐药性差异无显著性(P>0.05)。两组患者不同时间点的感染指标均存在差异,感染指标观察组术后1周、对照组术后6周基本恢复至正常水平(P<0.05)。观察组切口愈合时间、术后下地时间及住院时间短于对照组(P<0.05),观察组治愈率及总有效率均高于对照组(P<0.05)。术后观察组VAS、PHQ-9及GAD-7评分均较术前降低,且观察组低于对照组(P<0.05)。结论万古霉素氢氧化钙骨水泥治疗效果良好,且抗感染效果更佳。

Aim To observe the clinical effects of vancomycin calcium hydroxide bone cement on chronic osteomyelitis of lower limb long bone.Methods Seventy patients with chronic osteomyelitis of lower limbs were selected and randomly divided into control group(implanted with vancomycin calcium sulfate bone cement)and observation group(implanted with vancomycin calcium hydroxide bone cement).Preoperative bacterial examination and drug resistance were compared between the two groups.The infection index,incision healing time,postoperative ambulation time,hospitalization time,X-ray at 12 weeks after operation,and visual analogue scale(VAS),PHQ-9 and GAD-7 scores before and after operation were compared between the two groups.Results There was no significant difference in bacterial test and drug resistance between the two groups(P>0.05).The infection indexes of the two groups were different at different time points,and the infection indexes of the observation group and the control group recovered to the normal level 1 week after surgery(P<0.05).The wound healing time,postoperative time and hospital stay in the observation group were shorter than those in the control group(P<0.05),and the cure rate and total effective rate of the observation group were higher than those of the control group(P<0.05).VAS,PHQ-9 and GAD-7 scores in the observation group were lower than those before surgery,and the observation group was lower than the control group(P<0.05).Conclusion Vancomycin calcium hydroxide bone cement has good therapeutic effect and better anti-infection effect.