摘要
目的探讨万古霉素骨水泥（VCM-PMMA）对骨折内固定患者术后髓内感染的控制效果,为临床治疗骨折内固定髓内感染提供新思路。方法选择2010年12月-2013年6月在医院行内固定手术且术后髓内感染的骨科患者30例,在拆除髓内钉、切除窦道,扩髓后植入VCM-PMMA,术中采集髓腔炎性异物进行细菌培养和药敏分析,统计治疗前和治疗后临床资料,数据采用SPSS 19.0软件进行统计分析。结果 30例患者全部获得随访,随访时间10~22个月,平均（14.2±3.2）个月,感染控制时间2~5个月,平均（3.1±1.6）个月,感染控制痊愈25例、良3例、差2例,感染控制有效率93.3%,15例患者5d内体温恢复正常,其余在10d内恢复正常;术前CRP、WBC和ESR分别为（9.4±1.8）mg/L、（22.5±8.7）×109/L和（88.5±14.2）mm/h,术后分别为（6.8±1.3）mg/L、（13.2±7.4）×109/L和（25.4±12.7）mm/h（P〈0.05）。结论 VCM-PMMA对于骨折内固定患者术后髓内感染具有显著的控制效果,促进创面愈合,为临床骨科治疗术后感染提供新的技术参考。
OBJECTIVE To observe the effect of vancomycin-polymethylmethacrylate （VCM-PMMA） on control of postoperative intramedullary infections in fracture patients undergoing internal fixation so as to provide guidance for clinical treatment of the intramedullary infections. METHODS A total of 30 orthopedics department patients who underwent the internal fixation in the hospital from Dec 2010 to Jun 2013 were enrolled in the study. The VCM-PMMA was implanted after demolition of intramedullary nail, removal of antrum, and nail＇s being reamed, the medullary cavity inflammatory foreign bodies were intraoperatively collected for the bacterial culture, the drug susceptibility testing was carried out, the clinical data were taken for statistics before and after the treatment, and the,statistical analysis of data was performed with the use of SPSS 19.0 software. RESULTS All of the 30 patients received the ：follow-up for 10-22 months, with the mean duration （14.. 2±3.2）months; the time of control of infections was 245 moths, with the mean duration（3.1±1.6）months. Totally 25 patients with infections were cured, 3 cases were improved, and 2 cases were not controlled. The effective rate of control of the infections was 93.3 %. The body temperature of 15 patients retuned to normal within 5 days, and the body temperature of the rest of patients returned to normal within 10 days. The CRP level was （9.4±1.8）mg/L before the surgery, （6.8±1.3） mg/L after the surgery; the WBC level was （22.5±8.7） × 10^9/L before the surgery, （13.2±7.4） × 10^9/Lafter the surgery; the ESR level was（88.5±14.2）mm/h before the surgery, （25.4±12.7）mm/h after the surgery （P〈 0.05）. CONCLUSION The VCM-PMMA can achieve significant effect on control of the postoperative intramedullary infections in the fracture patients undergoing the internal fixation and facilitate the wound healing, which may provide guidance for clinical treatment of the postoperative infections in orthopedics department.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第24期5666-5668,共3页
Chinese Journal of Nosocomiology
基金
浙江省卫生厅基金资助项目(2013KYB225)
关键词
万古霉素骨水泥
骨折
内固定
术后
髓内感染
Vancomycin-polymethylmethacrylate
Fracture
Internal fixation
Postoperative
Intramedullary infection
