封闭式负压引流技术联合开放植骨治疗胫骨创伤性骨髓炎的效果观察

Effect of closed negative pressure drainage combined with open bone graft on patients with traumatic osteomyelitis of tibia

目的 分析胫骨创伤性骨髓炎(TTO)患者联合使用封闭式负压引流技术(VSD)和开放植骨的效果。方法 选择2021年8月至2022年8月在平煤神马医疗集团总医院就诊的70例TTO患者为研究对象,按照随机数字表法分为A组与B组,每组35例。A组采用开放植骨治疗,B组采用开放植骨联合VSD治疗。比较两组临床相关指标(VSD治疗次数、控制感染时间、骨折愈合时间、去除外固定时间、肉芽组织覆盖时间)、髋关节恢复情况、踝关节恢复情况及治疗有效率。结果 B组VSD治疗次数、控制感染时间、骨折愈合时间、去除外固定时间、肉芽组织覆盖时间均小于A组,差异有统计学意义(P<0.05)。术后3个月B组髋关节功能量表评分、踝关节功能量表评分优于A组,差异有统计学意义(P<0.05)。B组治疗有效率为97.14%(34/35)、术后并发症发生率为5.71%(2/35),优于A组[80.00%(28/35)、25.71%(9/35)],差异有统计学意义(χ^(2)=5.080、5.285,P=0.024、0.021)。结论 TTO患者联合使用VSD和开放植骨,改善髋关节、踝关节功能效果更佳,同时能提高骨折愈合效果,安全性较高。

Objective To analyze the effect of closed negative pressure drainage(VSD)combined with open bongerafting on patients with tibial traumatic osteomyelitis(TTO).Methods Seventy patients with TTO who were treated at Pingmei Shenma Medical Group General Hospital from August 2021 to August 2022 were selected as the research subjects.They were randomly divided into group A and group B according to the random number table method,with 35 cases in each group.The patients in group A were given open bone grafing grafting treatment,and the patients in group B were given open bone grafting combined with VSD treatment.The clinical related indicators(VSD treatment frequency,infection control time,fracture healing time,removal of external fixation time,granulation tissue coverage time),hip joint recovery status,ankle joint recovery status and treatment effects were compared between the two groups.Results The number of VSD treatments,infection control time,fracture healing time,removal of external fixation time,and granulation tissue coverage time in group B were all lower than those in group A,and the differences between the two groups were significant(P<0.05).Three months after surgery,the hip joint function scale scores and ankle joint function scale scores of group B were better than those of group A(P<0.05).The effective rate of treatment in group B was 97.14%(34/35),and the incidence of postoperative complications was 5.71%(2/35),which was superior to group A[80.00%(28/35)and 25.71%(9/35)](χ^(2)=5.080,5.285,P=0.024,0.021).Conclusions The combination of VSD and open bone grafting is more effective on improving hip joint and ankle joint function in patients with TTO,which can also improve fracture healing effect,and with higher safety.