[1]连志,贾乐,马月,等.膜诱导技术治疗胫骨慢性骨髓炎12例[J].中国中医骨伤科杂志,2023,31(11):61-65.[doi:10.20085/j.cnki.issn1005-0205.231112]
　LIAN Zhi,JIA Le,MA Yue,et al.Membrane Induction Technique on the Treatment of 12 Patients with Chronic Osteomyelitis of Tibia[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(11):61-65.[doi:10.20085/j.cnki.issn1005-0205.231112]
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膜诱导技术治疗胫骨慢性骨髓炎12例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年11期
页码:
61-65
栏目:
临床报道
出版日期:
2023-11-15

文章信息/Info

Title:
Membrane Induction Technique on the Treatment of 12 Patients with Chronic Osteomyelitis of Tibia
文章编号:
1005-0205(2023)11-0061-05
作者:
连志1; 贾乐2; 马月1; 卓乃强1; 阳运康1; 王冠1; 鲁晓波1; 葛建华1△
1西南医科大学附属医院骨科(四川 泸州,646000); 2绵阳市中心医院骨科
Author(s):
LIAN Zhi1; JIA Le2; MA Yue1; ZHUO Naiqiang1; YANG Yunkang1; WANG Guan1; LU Xiaobo1; GE Jianhua1△
1Department of Orthopedics,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan China; 2Department of Orthopedics,Mianyang Central Hospital,Mianyang 621000,Sichuan China.
关键词:
膜诱导技术;  骨髓炎;  感染;  胫骨
Keywords:
membrane induction technique;  osteomyelitis;  infection;  tibia
分类号:
R681.2
DOI:
10.20085/j.cnki.issn1005-0205.231112
文献标志码:
B
摘要:
目的:探讨膜诱导技术治疗胫骨慢性骨髓炎的临床应用及疗效分析。方法:自2019年1月至2022年6月,应用膜诱导技术治疗胫骨慢性骨髓炎患者12例。男9例,女3例; 年龄为22～60岁,平均为(41.6±11.7)岁。均为外伤致胫骨骨折,其中车祸伤8例,重物砸伤2例,坠落伤1例,火器伤1例; 8例为开放性骨折慢性骨髓炎伴骨不连,4例为闭合骨折内固定术后感染。入院后Ⅰ期彻底清创,填充抗生素骨水泥间隔物占位,闭合创面; Ⅱ期取出抗生素骨水泥间隔物,诱导膜内植骨,随访观察、记录、评估临床疗效。结果:12例患者两阶段手术间隔时间为6～8周,平均为(6.8±0.7)周,术后切口均Ⅰ期愈合。Ⅱ期术后随访12～40个月,平均为(21.4±7.6)个月,骨缺损均愈合,影像学检查愈合时间为4～7个月,平均为(5.3±1.2)个月,所有患者末次随访SF-36量表评分均较术前改善,差异有统计学意义(P<0.05),术后12个月随访时采用Paley评定标准评定,优良率为91.7%。结论:膜诱导技术治疗胫骨慢性骨髓炎疗程短,感染控制彻底,骨重建修复快,疗效确切满意,是临床治疗胫骨慢性骨髓炎及骨缺损的有效手段之一。
Abstract:
Objective:To investigate the clinical application and curative efficacy of membrane induction technique in treating chronic osteomyelitis of tibia.Methods:12 patients with chronic tibial osteomyelitis were treated with membrane induction technique from January 2019 to June 2022.There were 9 males and 3 females,age of 22 60(41.6±11.7)years old.All of them were tibial fractures caused by trauma,including 8 cases of traffic accident,2 cases of heavy object injury,1 case of falling injury and 1 case of firearm injury.8 patients had chronic osteomyelitis with nonunion in open fracture and 4 patients had infection after internal fixation in closed fracture.After admission,stage I was completely debridement,spacer filled with antibiotic bone cement to close the wound.In stage Ⅱ,antibiotic bone cement spacer was removed and intramembrane bone implantation was induced.The clinical efficacy was observed,recorded and evaluated during follow-up.Results:The interval between the two stages of operation was 68(6.8±0.7)weeks,and the incisions were all healed in stage I.All the bone defects were healed after 1240(21.4±7.6)months of postoperative follow-up in stage Ⅱ,and the imaging healing time was 47(5.3±1.2)months.The SF-36 scale scores of all patients were improved before and at the last follow-up compared with those before surgery(P<0.05).Paley's evaluation standard was used at 12 months of follow-up,and the excellent and good rate was 91.7%.Conclusion:Membrane induction technique is one of the effective methods for the treatment of chronic tibial osteomyelitis and bone defect with short course of treatment,thorough infection control,fast bone reconstruction and repair.

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备注/Memo

备注/Memo:
基金项目:四川省科技厅项目(2022YFS0628)
四川大学-泸州市人民政府联合项目(2022CDLZ-19)
西南医科大学-合江人民医院联合项目(2021HJXNY017)
△通信作者 E-mail:orthodrgjh@126.com
更新日期/Last Update: 2023-11-01