CAJ | 학술논문

目的探讨抗生素珠链在慢性骨髓炎治疗中的临床效果.方法将21例慢性骨髓炎患者行病灶清除,并随机分为观察组和对照组,对照组9例术后继续全身抗生素治疗,观察组12例患者采用抗生素珠链填充死腔和术后继续全身抗生素治疗,治疗3周后观察两组的临床效果,并进行比较分析.结果观察组12例患者骨折均达到或接近解剖复位并愈合,其中Ⅰ期骨折愈合11例,1例患者半年后因复发再次清创并植入抗生素珠链后骨折愈合,未愈0例,总有效率为100％,随访期间未见严重不良反应发生.对照组治愈3例,好转2例,未愈4例,总有效率为55.56％,1例发生针道感染,对症处理后得以缓解.两组比较差异有统计学意义(x2=7.283,P＜0.01).结论局部应用抗生素珠链填充治疗具有局部抗生素浓度高、缓慢释放、持续时间长、患者感觉较舒适、伤口闭合快、住院时间短、医疗费用低、不良反应少等优点,是治疗慢性骨髓炎较为理想的方法,值得临床大力广泛推广应用.
목적 탐토항생소주련재만성골수염치료중적림상효과.방법 장21례만성골수염환자행병조청제,병수궤분위관찰조화대조조,대조조9례술후계속전신항생소치료,관찰조12례환자채용항생소주련전충사강화술후계속전신항생소치료,치료3주후관찰량조적림상효과,병진행비교분석.결과 관찰조12례환자골절균체도혹접근해부복위병유합,기중Ⅰ기골절유합11례,1례환자반년후인복발재차청창병식입항생소주련후골절유합,미유0례,총유효솔위100％,수방기간미견엄중불량반응발생.대조조치유3례,호전2례,미유4례,총유효솔위55.56％,1례발생침도감염,대증처리후득이완해.량조비교차이유통계학의의(x2=7.283,P＜0.01).결론 국부응용항생소주련전충치료구유국부항생소농도고、완만석방、지속시간장、환자감각교서괄、상구폐합쾌、주원시간단、의료비용저、불량반응소등우점,시치료만성골수염교위이상적방법,치득림상대력엄범추엄응용.
Objective To investigate the clinical effect of antibiotic beads in the treatment of chronic osteomyelitis.Methods 18 patients with chronic osteomyelitis who had received focus debridement were randomly divided into observation group (12 cases) and control group (9 cases).Control group continued postoperative systemic antibiotic treatment,and observation group used antibiotic beads to fill dead space on the basis of control group.Compared and analyzed the clinical effect of two groups after 3 weeks.Results In observation group,fractures of 12 cases were all at or near anatomic reduction and healed,with 11 cases of Phase Ⅰ fracture healing; 1 cases recurred 6 months later,received debridement and antibiotic beads implantation,then recovered; the total effective rate was 100％,without serious adverse reaction during follow-up.In control group,3 cases were cured,2 cases were improved,4 cases were ineffective,with the total effective rate of 55.56％; 1 case of pin track infection recovered after symptomatic treatment.There was significant difference between two groups (x 2=7.283,P ＜ 0.01).Conclusions Topical application of antibiotics beads filling treatment has advantages such as high topical antibiotic concentration,slow release,long lasted time,comfort for patients,faster wound closure,shorter hospitalization time,low cost and less adverse reaction,which is an ideal method in the treatment of chronic osteomyelitis,worthy of clinical application.