摘要
目的探讨开槽对流技术联合载药硫酸钙联合应用于下肢骨折髓内钉固定术后感染的临床疗效。方法回顾性分析2018年6月至2024年6月新疆维吾尔自治区人民医院收治的42例下肢骨折髓内钉术后感染患者资料,其中男30例,女12例;年龄20~65岁,平均(35.0±3.0)岁。其中股骨髓内钉术后感染15例,胫骨髓内钉术后感染27例;病程3~10个月,平均(5.0±1.5)个月。均采用开槽对流技术联合载药硫酸钙治疗。术后根据临床症状消失时间、感染指标(血常规、C反应蛋白、血沉、降钙素原)正常化时间、影像学检查、术后复发率和功能恢复情况综合评价治疗效果。结果术后随访6~12个月,平均(10.0±1.5)个月。40例(95.2%)一期治愈;2例术后复发,再次治疗后症状消失。术后临床症状消失时间3~6个月,平均(4.0±0.5)个月;实验室感染指标恢复正常时间3~7个月,平均(5.0±1.5)个月;影像学检查结果恢复正常时间5~10个月,平均(7.0±1.5)个月。术后肢体功能恢复Paley评分,优34例(81.0%),良5例(11.9%),可3例(7.1%),优良率92.9%。结论开槽对流技术联合载药硫酸钙治疗下肢骨折髓内钉固定术后感染,临床效果显著,术后复发率低,可显著缩短骨折愈合时间,且减少了抗生素使用量,降低了药物毒副作用的风险,具有临床推广价值。
Objective To evaluate the clinical efficacy of slot drainage technique combined with drug-loaded calcium sulfate in treating postoperative infections following intramedullary nailing of lower limb fractures.Methods A retrospective analysis was conducted on 42 patients with postoperative infections after intramedullary nailing of lower limb fractures treated at the People’s Hospital of Xinjiang Uygur Autonomous Region from June 2018 to June 2024.The cohort included 30 males and 12 females,aged 20~65 years[mean(35.0±3.0)years].Among them,15 cases involved femoral intramedullary nailing infections,and 27 cases involved tibial intramedullary nailing infections.The disease duration ranged from 3 to 10 months[mean(5.0±1.5)months].All patients were treated with slot drainage technique combined with drug-loaded calcium sulfate.Postoperative outcomes were comprehensively evaluated based on the time to resolution of clinical symptoms,normalization of infection markers(complete blood count,C-reactive protein,erythrocyte sedimentation rate,procalcitonin),radiographic findings,recurrence rate,and functional recovery.Results Postoperative follow-up ranged from 6 to 12 months[mean(10.0±1.5)months].Primary healing was achieved in 40 cases(95.2%),while 2 cases experienced recurrence but resolved after retreatment.The time to resolution of clinical symptoms postoperatively was 3~6 months[mean(4.0±0.5)months].Laboratory infection markers normalized within 3~7 months[mean(5.0±1.5)months],and radiographic recovery occurred within 5~10 months[mean(7.0±1.5)months).Functional recovery assessed by the Paley score was excellent in 34 cases(81.0%),good in 5 cases(11.9%),and fair in 3 cases(7.1%),with an excellent-to-good rate of 92.9%.Conclusion Slot drainage technique combined with drug-loaded calcium sulfate for postoperative infection after intramedullary nailing of lower limb fractures yields significant clinical results,low postoperative recurrence rate,markedly shortened fracture healing time,reduced antibiotic consumption,and lowered risk of drug toxicity,thus demonstrating clinical value for wider application.
作者
石守印
周敏
海拉提·巴合提
哈巴西·卡恩
徐江波
孙俊刚
Shi Shouyin;Zhou Min;Hairati Baheti;Habaxi Kahn;Xu Jiangbo;Sun Jungang(Orthopedic Center,Xinjiang Uyghur Autonomous Region People's Hospital,Urumqi 830001,China;Neurosurgery Department,Xinjiang Production and Construction Corps Hospital,Urumqi 830001,China.)
出处
《实用骨科杂志》
2025年第8期689-693,共5页
Journal of Practical Orthopaedics
关键词
髓内钉固定术
术后感染
开槽对流技术
载药硫酸钙
intramedullary nailing
postoperative infection
slot drainage technique
drug-loaded calcium sulfate
作者简介
通信作者:周敏;石守印(1979-),副主任医师,新疆维吾尔自治区人民医院骨科中心,shishouyin@qq.com。
