[1]谭新欢,段来宝,毕宏政,等.复方蜈蚣颗粒结合外固定骨搬移技术治疗开放性胫骨骨折术后感染的疗效观察[J].中国中医骨伤科杂志,2022,30(12):66-71.
　TAN Xinhuan,DUAN Laibao,BI Hongzheng,et al.Observation of Curative Efficacy of Compound Centipedes Granule Combined with Ilizarov Technique in Treating Postoperative Infection of Open Tibial Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(12):66-71.
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复方蜈蚣颗粒结合外固定骨搬移技术治疗开放性胫骨骨折术后感染的疗效观察()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年12期
页码:
66-71
栏目:
临床报道
出版日期:
2022-12-15

文章信息/Info

Title:
Observation of Curative Efficacy of Compound Centipedes Granule Combined with Ilizarov Technique in Treating Postoperative Infection of Open Tibial Fracture
文章编号:
1005-0205(2022)12-0066-06
作者:
谭新欢1; 段来宝1; 毕宏政1; 杨庆民1; 聂伟志1; 张峻玮1; 杨勇2△
1山东省文登整骨医院(山东 威海,264400) 2北京积水潭医院
Author(s):
TAN Xinhuan1; DUAN Laibao1; BI Hongzheng1; YANG Qingmin1; NIE Weizhi1; ZHANG Junwei1; YANG Yong2△
1Wendeng Hospitial of Traditional Chinese Orthopedics and Traumatology of Shandong Province, Weihai 264400, Shandong China; 2Beijing Jishuitan Hospital, Beijing 100035, China.
关键词:
伊利扎洛夫技术;  感染;  开放性骨折;  外固定器;  骨搬移
Keywords:
Ilizarov technique;  infection;  openness fracture;  external fixator;  bone removal
分类号:
R683.42
文献标志码:
B
摘要:
目的:探讨运用复方蜈蚣颗粒结合Ilizarov技术治疗开放性胫骨骨折术后感染的临床疗效及安全性。方法:采用回顾性病例系列研究分析2017年2月至2021年1月收治的37例开放性胫骨骨折术后感染患者的病例资料,所有患者均采用感染骨段切除、Ilizarov技术治疗,必要时采用负压引流术及皮瓣转移修复创面,术后口服中成药复方蜈蚣颗粒。根据末次随访Paley感染性骨缺损骨愈合评分标准和邻近关节功能评定进行临床疗效评价。结果:37例患者均获随访,随访时间为14～36个月,平均为18.6个月,所有伤口及骨折均愈合,感染未复发; 术后1个月白细胞计数(WBC)、C反应蛋白(CRP)及红细胞沉降率(ESR)指标较术前均明显降低,差异有统计学意义(P<0.05); 伤口愈合时间为14～32 d,平均为18 d; 骨愈合时间为6.3～13.8个月,平均为10.2月。末次随访根据Paley感染性骨缺损骨愈合评分标准评价结果:优14例,良18例,优良率为86.5%。邻近关节功能评定结果:优11例,良19例,优良率为81.1%。结论:复方蜈蚣颗粒结合Ilizarov技术治疗开放性胫骨骨折术后感染疗效安全可靠,有助于肢体功能的恢复,值得临床推广应用。
Abstract:
Objective:To investigate the clinical efficacy and safety of compound centipedes granule combined with Ilizarov technique on the treatment of postoperative infection of open tibial fracture.Methods:A retrospective case-series study was conducted to analyze the clinical data of 37 patients with postoperative infection of open tibial fractures from February 2017 to January 2021.All patients were treated by resection of infected bone segment and Ilizarov technique, and if necessary, negative pressure drainage and skin flap transfer were used to repair the wound.Traditional Chinese medicine compound centipede granules was taken orally after operation.The healing of infected bone defects and the assessment of adjacent joint function were used to evaluated clinical efficacy according to the Paley's scoring system.Results:All the 37 patients were followed up for 14 to 36 months with 18.6 months on average.Wounds and fractures were healed without recurrence of infection.White blood cell(WBC), C-reaction protein(CRP)and erythrocyte sedimentation rate(ESR)were significantly lower 1 month after operation than those before operation(P<0.05).The healing time of wounds was 14 to 32 d, with 18 d on average; the healing time of fracture was 6.3 to 13.8 months, with 10.2 months on average.Paley's scoring system results showed that: the excellent and good rate was 86.5% including excellent in 14 cases and good in 18 cases.The results of evaluation of adjacent joint function: excellent in 11 cases,good in 19 cases, the rate of excellent and good was 81.1%.Conclusion:Compound centipedes granule combined with Ilizarov technique is safe and reliable on the treatment of postoperative infection of open tibial fracture, which is helpful to the recovery of limb function and worthy of clinical application.

参考文献/References:

[1] 周上清,张琦,丁相东,等.锁定钢板外置联合膜诱导技术治疗胫骨开放 粉碎性骨折伴骨缺损[J].中医骨伤,2021,34(5):400-405.
[2] 高长虹,石学峰,白志娟,等.开放性胫骨骨折创面感染病原学特点与愈合影响因素分析[J].中华医院感染学杂志,2019,29(10):1536.
[3] SIMPSON A H R W,TSANG S T J.Non-union after plate fixation[J].Injury,2018,49(Suppl 1):S78-S82.
[4] YASUDA T,ARAI M,SATO K,et al.A Gustilo type 3B open tibial fracture treated with a proximal flexor hallucis longus flap:a case report[J].J Orthop Case Rep,2017,7(2):70-73.
[5] 林昌请,桑莉莉,梁武胜,等.骨搬移技术对下肢大段骨缺损的临床疗效研究[J].中国中医骨伤科杂志,2019,27(10):48-53.
[6] PALEY D,CATAGNI M A,ARGNANI F,et al.Ilizarov treatment of tibial nonunions with bone loss[J].Clin Orthop Relat Res,1989(241):146-165.
[7] 殷渠东,顾三军,芮永军,等.诱导膜技术治疗骨缺损的疗效分析[J].中华骨科杂志,2016,36(20):1284-1292.
[8] 张彦龙,张胜,李凯,等.骨折内固定术后超晚期感染诊疗效果初步探讨[J].中华创伤杂志,2022,38(1):67.
[9] 况志辉,潘志军.创伤后骨感染合并骨缺损临床治疗技术研究进展[J].中华创伤杂志,2020,36(8):755-758.
[10] WU X Q,ZHANG D D,WANG Y N,et al.AGE/RAGE in diabetic kidney disease and ageing kidney[J].Free Radic Biol Med,2021,171:260-271.
[11] 艾双艳,李卫国,冯亚东,等.全蝎化学成分的研究[J].中成药,2017,39(8):1639-1641.
[12] 蔡渊卿,方心俞,张翀景,等.成骨细胞吞噬内化金黄色葡萄球菌在骨髓炎发病机制中的作用[J].中华骨与关节外科杂志,2020,13(8):681-687.
[13] 郭锦辉,邓智建,卢乙众,等.芪蛭通络胶囊联合脑苷肌肽治疗脑梗死恢复期的临床研究[J].现代药物与临床,2021,36(4):680-684.
[14] 李蓉蓉,游蓉丽,秦雪梅,等.基于UPLC-Q-Orbitrap HRMS 技术快速识别芪蛭通络胶囊化学成分[J].中国中药杂志,2020,45(20):4918-4928.
[15] 国家药典委员会.中华人民共和国药典:2020 年版一部[S].北京:中国医药科技出版社,2020:237-238.
[16] 龚兴成,刘文静,曹丽波,等.DI-MS/MS～(ALL)法快速定性分析金银花的化学成分[J].中国中药杂志,2021,46(9):2220-2228.
[17] 李中峰,陈明海,凡一诺,等.右归饮治疗激素性股骨头坏死作用机制的网络药理学分析[J].中国组织工程研究,2021,25(8):1256-1263.
[18] 谭德重,阎艾慧.VEGF与EGFR在鼻息肉发病机制中的研究进展[J].医学综述,2019,25(11):2133-2137.
[19] KLEIN C,MONET M,BARBIER V,et al.The Masquelet technique:current concepts,animal models,and perspectives[J].J Tissue Eng Regen Med,2020,14(9):1349-1359.
[20] RADOSAVL JEVIC M,LEVI S,BELO VIé M,etal.Immobilization of Lactobacillus rhamnosus in polyvinylalcohol/calcium alginate matrix for production of lacticacid[J].Bioprocess Biosyst Eng,2020,43(2):315-322.
[21] 贺国宇,周鑫,石颖,等.超声监测下手风琴技术促进胫骨搬移术后对合端骨愈合的临床效果和影像学表现[J].中华外科杂志,2021,59(6):477-482.
[22] 衡德忠,李静,翟江波,等.个体化可控性应力外固定技术在胫骨开放性骨折中的应用[J].中国骨伤,2021,34(10):915-918.
[23] 徐玉德,徐玉娥,周明旺,等.手风琴技术治疗骨不愈合的分子机制研究进展[J].中国矫形外科杂志,2020,28(14):1288-1290.
[24] 位春巍,陈嘉怡,郑臣校.伤科九味健骨片对家兔骨短缩延长后血清骨钙素及骨组织的影响[J].中国中医骨伤科杂志,2022,30(2):1-7.

备注/Memo

备注/Memo:
基金项目:山东省中医药科技项目(2021M062) 国家中医药管理局全国名老中医药专家传承工作室 建设项目(国中医药人教函〔2022〕75号) △通信作者 E-mail:0414yang@sina.com
更新日期/Last Update: 2022-12-10