CAJ | 학술논문

目的探讨多网管解剖型置管灌洗法在骨折术后继发慢性骨髓炎治疗中的应用价值.方法回顾性分析2006年6月至2008年12月收治的骨折术后继发慢性骨髓炎患者40例(41处)的病例资料,男35例,女5例;年龄16～68岁,平均42.7岁.对40例(41处)采用彻底清创、闭合死腔、多网管解剖型置管灌洗引流、全身及局部应用敏感抗生素等系列疗法治疗3～4周.术后每3个月复查,包括切口愈合情况、X线片表现、红细胞沉降率和C-反应蛋白.按灌洗治疗结束时炎症是否稳定及术后6个月时炎症是否复发制定疗效评价标准,参考指标包括伤口愈合情况、全身症状、红细胞沉降率及C-反应蛋白等.结果按上述疗效判定标准,优37例,切口一期愈合,术后6个月时无复发;良2例,切口愈合稍差,经换药治疗后愈合,术后6个月时无复发;差1例,窦道复发,切口未愈.36例在术后半年行植骨内固定术,术后骨折愈合,4例未经植骨直接愈合.随访30～50个月,平均43.2个月,均无复发.结论多网管解剖型置管灌洗法对于骨折术后继发慢性骨髓炎的治愈率高,可操作性强,术后好管理,是一种有效的治疗方法.
목적 탐토다망관해부형치관관세법재골절술후계발만성골수염치료중적응용개치.방법 회고성분석2006년6월지2008년12월수치적골절술후계발만성골수염환자40례(41처)적병례자료,남35례,녀5례;년령16～68세,평균42.7세.대40례(41처)채용철저청창、폐합사강、다망관해부형치관관세인류、전신급국부응용민감항생소등계렬요법치료3～4주.술후매3개월복사,포괄절구유합정황、X선편표현、홍세포침강솔화C-반응단백.안관세치료결속시염증시부은정급술후6개월시염증시부복발제정료효평개표준,삼고지표포괄상구유합정황、전신증상、홍세포침강솔급C-반응단백등.결과 안상술료효판정표준,우37례,절구일기유합,술후6개월시무복발;량2례,절구유합초차,경환약치료후유합,술후6개월시무복발;차1례,두도복발,절구미유.36례재술후반년행식골내고정술,술후골절유합,4례미경식골직접유합.수방30～50개월,평균43.2개월,균무복발.결론 다망관해부형치관관세법대우골절술후계발만성골수염적치유솔고,가조작성강,술후호관리,시일충유효적치료방법.
Objective To explore the clinical application of the multi-network anatomical lavage on the treatment of chronic osteomyelitis after fracture surgery. Methods A retrospective analysis of 40 patients (41 sites) with chronic osteomyelitis after fracture surgery was performed from June 2006 to December 2008. There were 35 males and 5 females with an average of 42.7 years (range, 16-68). All 40 cases were treated with debridement, closing the cavity, and placing the multi-tube drainage network anatomical catheter lavage system. At the same time, sensitive antibiotics were used for 3 to 4 weeks. Rechecks were scheduled every 3 months after operation, including wound healing, X-ray presentation, ESR and C-reactive protein.Cure criteria depends on the conditions of the inflammation when the lavage treatment was over, and whether it relapsed six months after operation, including wound healing, systemic symptoms, ESR and C-reactive protein. Results Judged by the clinical outcomes when the lavage treatment was over and six months after operation, the effects were categorized into 3 levels, including excellent in 37 cases with primary wound healing, and without relapse six months later;, good in 2 with poor wound healing, the wound healed after a period of treatment without recurrence; poor in one with recurrent sinus infection and a prolonged unhealed wound, after another operation he was healed. 36 cases were treated with bone graft and internal fixation operation, and the fractures were healed after surgery, the fractures were healed directly in 4 cases without bone graft. The patients were followed up for an average of 43.2 months (range, 30-50) after operation, and none relapsed. Conclusion The multi-tube drainage network anatomical method is feasible and effective on the treatment of chronic osteomyelitis after fracture surgery with a high cure rate.