万古霉素骨水泥对感染性骨缺损骨折愈合的影响

Effect of Vancomycin bone cement on fracture healing of infected bone defect

目的探究万古霉素骨水泥对感染性骨缺损患者骨折愈合及炎症因子水平的影响。方法选取2019年1月至2020年12月贵阳市第四人民医院收治的64例感染性骨缺损患者作为研究对象,按照随机数字表法将其分为对照组(32例)与研究组(32例),对照组接受常规清创引流治疗,研究组在对照组基础上采用万古霉素复合型骨水泥植入治疗,比较两组患者骨折愈合优良率、炎症因子改善情况以及术后肢体功能恢复情况。结果研究组患者的骨折愈合优良率、术后关节功能恢复优良率高于对照组,差异有统计学意义(P<0.05)。术后,两组患者白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞计数(WBC)水平低于本组术前,研究组患者IL-6、TNF-α、ESR、CRP、WBC水平低于对照组,差异有统计学意义(P<0.05)。术后,两组患者平均通过时间(MTT)短于本组术前,血容量(BV)、血流量(BF)水平高于本组术前,研究组患者MTT短于对照组,BV、BF水平高于对照组,差异有统计学意义(P<0.05)。术后,两组患者血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)、骨形态发生蛋白2(BMP-2)水平高于本组术前,研究组患者VEGF、TGF-β1、BMP-2水平高于对照组,差异有统计学意义(P<0.05)。结论对感染性骨缺损患者实施万古霉素复合型骨水泥植入治疗可有效降低炎症因子水平,促进患者骨折愈合,改善肢体功能。

Objective To explore the effects of Vancomycin bone cement on fracture healing and inflammatory factors in patients with infectious bone defect.Methods A total of sixty-four patients with infectious bone defect admitted to the Fourth People's Hospital of Guiyang from January 2019 to December 2020 were selected as the study objects,and were divided into control group(32 cases)and study group(32 cases)according to random number table method.The control group received routine debridement and drainage treatment,and the study group received Vancomycin composite bone cement implantation treatment on the basis of the control group.The excellent rate of fracture healing,the improvement of inflammatory factors and the recovery of limb function were compared between the two groups.Results The rate of fracture healing and postoperative joint function recovery in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).After operation,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and white blood cell count(WBC)in 2 groups were lower than those before operation,and the levels of IL-6,TNF-α,ESR,CRP and WBC in research group were lower than those in control group,with statistical significances(P<0.05).After surgery,the mean transit time(MTT)level of patients in the two groups was shorter than before surgery,and the blood volume(BV)and blood flow(BF)levels were higher than before surgery,and the MTT level of patients in the study group was shorter than that of the control group,and the BV and BF levels were higher than that of the control group,with statistical significances(P<0.05).After operation,the levels of vascular endothelial growth factor(VEGF),transforming growth factorβ1(TGF-β1)and bone morphogenetic protein 2(BMP-2)in two groups were higher than those before operation,and the levels of VEGF,TGF-β1 and BMP-2 in study group were higher than those in control group,with statistical significances(P<0.05).Conclusion Vancomycin composite bone cement implantation in patients with infectious bone defects can effectively reduce the level of inflammatory factors,promote fracture healing and improve limb function.