Efficacy of Vancomycine Combined with Bone Transfer Surgery in the Treatment of MRSA-Infected Traumatic Osteomyelitis of Tibia and Its Effects on Serum TLR4,TNF-α and PCT Levels
OBJECTIVE:To probe into the efficacy of vancomycin combined with bone transfer surgery in the treatment of methicillin resistant Staphylococcus aureus(MRSA)infected traumatic osteomyelitis of tibia and its effects on serum Toll-like receptor 4(TLR4),tumor necrosis factor α(TNF-α)and procalcitonin(PCT).METHODS:A total of 120 patients with MRSA-infected traumatic osteomyelitis of tibia admitted into Haikou People's Hospital Affiliated to Xiangya School of Medicine of Central South University from Apr.2020 to Apr.2022 were selected to be divided into control group,observation group 1 and observation group 2 by using computer-generated random number series,with 40 cases in each group.The control group was given conventional surgery,the observation group 1 was given bone transfer surgery,the observation group 2 was given vancomycin combined with bone transfer surgery.The serum TLR4,TNF-α and PCT levels were compared among three groups,the clinical efficacy,MRSA clearance rates,inflammatory indicators[white blood cell count(WBC),serum C reactive protein(CRP)and interleukin 6(IL-6)]and hemorheological indicators(plasma viscosity,whole blood viscosity,fibrinogen,hematokrit,erythrocyte sedimentation rate,erythrocyte aggregation index)of the three groups were observed.RESULTS:After 2 weeks of treatment,the TLR4,TNF-α and PCT levels of observation group 2 were lower than those of the control group and the observation group 1,with statistically significant differences(P<0.05).After 2 weeks of treatment,the total effective rate and MRSA clearance rate of observation group 2 were respectively 92.50%(37/40)and 90.00%(36/40),higher than those of the control group[80.00%(32/40)and 75.00%(30/40)]and the observation group 1[85.00%(34/40)and 80.00%(32/40)],with statistically significant differences(P<0.05).After 2 weeks of treatment,the WBC,CRP and IL-6 levels,plasma viscosity,whole blood viscosity,fibrinogen,hematokrit and erythrocyte sedimentation rate of observation group 2 were lower than those of the control group and the observation group 1,while the erythrocyte aggregation index of observation group 2 was higher than that of the control group and observation group 1,with statistically significant differences(P<0.05).CONCLUSIONS:The efficacy of vancomycin combined with bone transfer surgery in the treatment of MRSA infected traumatic osteomyelitis of tibia is remarkable,which can effectively inhibit the increasing of serum TLR4,TNF-α and PCT levels.
VancomycinBone transfer surgeryTraumatic osteomyelitisMethicillin resistant Staphylococcus aureus infection
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