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外固定支架联合负载抗生素硫酸钙对胫腓骨开放性骨折患者术后感染及骨愈合的影响 被引量:4

Influence of external fixator combined with antibiotic-impregnated calcium sulfate on postoperative infection and bone healing in patients with open tibia and fibula fractures
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摘要 目的探讨外固定支架联合负载抗生素硫酸钙对胫腓骨开放性骨折患者术后感染及骨愈合的影响。方法选取2017年6月-2020年6月海南医学院第一附属医院收治的83例胫腓骨开放性骨折患者,采用投掷法随机分为观察组(n=41)与对照组(n=42)。对照组采用外固定支架治疗,观察组采用外固定支架联合负载抗生素硫酸钙治疗。比较两组骨愈合情况(包括完全负重时间、肿胀消除时间、外固定支架拆除时间、骨愈合时间)、膝关节功能(HSS评分)、踝关节功能(AOFAS评分)、生活质量及并发症发生情况。结果两组一般资料比较差异无统计学意义(P>0.05);观察组完全负重时间、肿胀消除时间、外固定支架拆除时间、骨愈合时间均短于对照组(P<0.05)。治疗前,两组HSS评分、AOFAS评分及SF-36量表各维度评分比较差异无统计意义(P>0.05);治疗后,两组HSS评分、AOFAS评分均高于治疗前(P<0.05),且观察组高于对照组(P<0.05),两组SF-36量表各维度评分均高于治疗前(P<0.05),且观察组精力、总体健康、生理机能3个维度评分高于对照组(P<0.05)。术后两组畸形愈合、骨不连、肌力减退的发生率差异无统计学意义(P>0.05),但观察组伤口感染发生率低于对照组(P<0.05)。结论胫腓骨开放性骨折患者采用外固定支架联合负载抗生素硫酸钙治疗疗效较高,可明显降低术后感染发生率,加速骨愈合。 Objective To explore the influence of external fixator combined with antibiotic-impregnated calcium sulfate on postoperative infection and bone healing in patients with open tibia and fibula fractures.Methods A total of 83 patients with open tibia and fibula fractures admitted to the First Affiliated Hospital of Hainan Medical College from June 2017 to June 2020 were selected,and according to the throwing method randomly divided into observation group(n=41)and control group(n=42).Patients in the control group were treated with external fixator,and those in the observation group were treated with external fixator combined with antibiotic-impregnated calcium sulfate.The bone healing(including complete weight bearing time,swelling elimination time,external fixator removal time,bone healing time),knee function(HSS score),ankle function(AOFAS score),quality of life,and incidence of complications were compared between the two groups.Results There was no statistically significant difference in the general data between the two groups(P>0.05).The complete weight bearing time,swelling elimination time,external fixator removal time,and bone healing time in observation group were shorter than in control group(P<0.05).There was no statistically significant difference in HSS score,AOFAS score and SF-36 score between the two groups before treatment(P>0.05).After treatment,the HSS scores and AOFAS scores of the two groups increased,and the observation group had higher scores than the control group(P<0.05).The SF-36 scores of the two groups increased,and the scores for energy,general health and physiological function in observation group were higher than in control group(P<0.05).There was no statistically significant difference in the incidence of malunion,nonunion and decreased muscle strength between the two groups(P>0.05),but the incidence of wound infection was lower in observation group than in control group(P<0.05).Conclusion External fixator combined with antibiotic-impregnated calcium sulfate is effective in treatment of patients with open tibia and fibula fractures,which can significantly reduce the postoperative infection rate and accelerate bone healing.
作者 唐崧杰 崔红旺 王挺锐 Tang Song-Jie;Cui Hong-Wang;Wang Ting-Rui(Spinal Osteopathy Surgery,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan 570102,China)
出处 《解放军医学杂志》 CAS CSCD 北大核心 2023年第9期1034-1039,共6页 Medical Journal of Chinese People's Liberation Army
基金 国家自然科学基金(81760260)。
关键词 外固定支架 抗生素 硫酸钙 胫腓骨开放性骨折 感染 external fixator antibiotic calcium sulfate open tibia and fibula fractures infection
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