病灶清除载抗生素硫酸钙植入治疗锁骨骨髓炎21例
Debridement and Antibiotic-Loaded Calcium Sulfate Implantation for the Treatment of Clavicular Osteomyelitis
杨瑞芳 1王新卫 2王石林 1刘欣欣 1郭再冉 2钟文龙 2张磊 2陈江非2
作者信息
- 1. 河南中医药大学(郑州,450046);河南省洛阳正骨医院(河南省骨科医院)骨与关节感染一科
- 2. 河南省洛阳正骨医院(河南省骨科医院)骨与关节感染一科
- 折叠
摘要
目的:探讨病灶清除载抗生素硫酸钙植入治疗锁骨骨髓炎的疗效.方法:回顾性分析2016年1月至2022年6月,采用病灶清除载抗生素硫酸钙治疗的21例锁骨骨髓炎患者临床资料.记录手术时间、感染控制情况、有无感染复发及并发症情况,末次随访采用视觉模拟量表(VAS)评分及Constant肩关节功能评分评估肩关节功能恢复情况.结果:21例患者均顺利进行手术,手术时间为55～150 min,平均为(94.52±20.12)min.所有患者均获随访,时间为13～37个月,平均为(27.86±5.93)个月.术后7 d患者红细胞沉降率(ESR)、白细胞(WBC)和C-反应蛋白(CRP)等血清炎性指标均较术前降低,差异有统计学意义(P＜0.05).术后2周患部肿痛基本消失,手术切口愈合良好.2例感染复发,经再次病灶清除载抗生素硫酸钙植入后治愈,感染复发率为2/21,均未出现病理性骨折.术后3个月复查X线片可见载抗生素硫酸钙均基本降解吸收.末次随访VAS评分和Constant肩关节功能评分均较术前明显改善,差异有统计学意义(P＜0.05),患侧肩关节功能均基本恢复正常.结论:病灶清除载抗生素硫酸钙植入治疗锁骨骨髓炎可有效控制感染,保留锁骨的外形与功能,术后感染复发率低,手术操作简单,且无严重并发症,值得临床推广应用.
Abstract
Objective:To investigate the efficacy of debridement and antibiotic-loaded calcium sulfate implantation for the treatment of clavicular osteomyelitis.Methods:Retrospective analyzed clinical data of 21 patients with clavicular osteomye-litis treated with debridement and antibiotic-loaded calcium sulfate implantation from January 2016 to June 2022.The oper-ation time,infection control,hospital stay,the presence of infection recurrence and complications were recorded,and the re-covery of shoulder function was assessed by visual analogue scale(VAS)score and Constant shoulder function score at the final follow-up.Results:All 21 patients underwent surgery successfully,and the operative time ranged from 55 to 150 min,with an average of(94.52±20.12)min.All patients were followed up for 13 to 37 months,with an average of(27.86±5.93)months.Serum inflammatory indexes such as erythrocyte sedimentation rate(ESR),white blood cells(WBC)and C-reactive protein(CRP)were reduced in patients at 7 d after surgery compared with preoperatively(P＜0.05).The swelling and pain of the affected area disap-peared basically at 2 weeks after surgery,and the surgical incision healed well.2 cases of recurrence of infection were cured after debridement with antibiotic-loaded calcium sulfate implantation again,with a recurrence rate of infection of 2/21 and none of them had pathological fractures.At the last follow-up,the VAS score and Constant shoulder function score were significantly improved compared to those before surgery(P＜0.05),and the function of the affected shoulder joint was basically restored to normal.Conclusion:Debridement and antibiotic-loaded calcium sulfate implantation for the treatment of clavicular osteomyelitis not only can effectively control infection,preserve the shape and function of the clavi-cle well,but also have a low recurrence rate of postoperative infection,simple surgical operation,and no serious complica-tions,which is worthy of clinical promotion.
关键词
锁骨骨髓炎/病灶清除/载抗生素硫酸钙Key words
clavicular osteomyelitis/debridement/antibiotic-loaded calcium sulfate引用本文复制引用
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20230486)
洛阳市社会发展类公益专项医疗卫生重点项目(2302019A)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据