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。
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 osteomyelitis treated with debridement and antibiotic-loaded calcium sulfate implantation from January 2016 to June 2022.The operation time,infection control,hospital stay,the presence of infection recurrence and complications were recorded,and the recovery 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 disappeared 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 clavicle well,but also have a low recurrence rate of postoperative infection,simple surgical operation,and no serious complications,which is worthy of clinical promotion.
作者
杨瑞芳
王新卫
王石林
刘欣欣
郭再冉
钟文龙
张磊
陈江非
YANG Ruifang;WANG Xinwei;WANG Shilin;LIU Xinxin;GUO Zairan;ZHONG Wenlong;ZHANG Lei;CHEN Jiangfei(Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China;Department of Bone and Joint Infection,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Luoyang 471000,Henan China)
出处
《中国中医骨伤科杂志》
CAS
2024年第1期71-75,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
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)。
关键词
锁骨骨髓炎
病灶清除
载抗生素硫酸钙
clavicular osteomyelitis
debridement
antibiotic-loaded calcium sulfate
作者简介
通信作者:王新卫,E-mail:lywxw188@163.com。
