[1]任飞龙,郭俊,周大鹏,等.膜诱导技术治疗成人创伤后骨髓炎[J].中医正骨,2017,29(11):50-54.
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膜诱导技术治疗成人创伤后骨髓炎()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年11期
页码:
50-54
栏目:
学术探讨
出版日期:
2017-11-20

文章信息/Info

作者:
任飞龙郭俊周大鹏陈语
中国人民解放军沈阳军区总医院,辽宁 沈阳 110801
关键词:
骨髓炎 骨缺损 膜诱导技术
摘要:
目的:探讨膜诱导技术治疗成人创伤后骨髓炎的临床疗效和安全性。方法:2013年3月至2016年4月,采用膜诱导技术治疗成人创伤后骨髓炎患者35例,男30例、女5例; 年龄19~70岁,中位数39岁; 胫骨16例,股骨17例,尺骨2例; 均于伤后急诊行开放性骨折清创探查、抗生素链珠植入、负压封闭引流技术及外固定架固定术,术后出现红肿热痛等表现; 负压引流管均引出脓性分泌物,细菌培养均为阳性,其中金黄色葡萄球菌16例、大肠杆菌4例、草绿色链球菌3例、鲍曼不动杆菌4例、混合性细菌感染8例。病程5~9个月,中位数7个月。随访观察骨愈合、患肢功能恢复、患者生存质量及并发症发生情况。结果:所有患者均获随访,随访时间13~48个月,中位数21个月。31例患者获得一期骨愈合,愈合时间4~9个月,中位数6个月; 1例出现骨缺损处感染, 再次行膜诱导手术后骨愈合; 2例出现二期植骨吸收,再次行彻底清创植骨术后骨愈合; 1例出现皮瓣坏死和骨缺损处感染,再次行皮瓣修复术、膜诱导手术及积极抗感染治疗后皮瓣成活、骨愈合。2例出现髂骨切口处感染,经清创后感染得到控制; 其余患者无明显并发症发生。末次随访时,28例患肢恢复良好,可正常负重行走; 3例出现下肢短缩,分别短缩0.8 cm、1.5 cm和1 cm,但不影响行走; 4例患肢出现轻微畸形愈合,但不影响正常活动; SF-36健康调查量表总评分由术前(51.22±9.28)分升高至(73.30±9.18)分。结论:采用膜诱导技术治疗成人创伤后骨髓炎,操作简单,能促进骨愈合,有利于患肢功能恢复,改善患者生存质量,并发症较少,值得临床推广应用。

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更新日期/Last Update: 2018-04-02