碳酸氢钠治疗开放性胫骨骨折伴感染的临床研究

目的探讨碳酸氢钠在治疗胫骨开放性骨折伴感染中的作用。方法胫骨开放性骨折伴感染患者根据骨折开放程度随机分为常规治疗组与碳酸氢钠治疗组。常规治疗组患者给予骨折复位,感染创口局部冲洗,静脉滴注抗生素抗感染治疗;碳酸氢钠治疗组在常规治疗的基础上给予碳酸氢钠静脉滴注与感染创口局部冲洗。治疗前创口感染伤口渗出液行涂片找细菌与测定pH值,并在治疗前、后检测血pH值及电解质的变化。结果感染伤口感染菌主要为铜绿假单胞菌,其次为大肠埃希菌。铜绿假单胞菌感染伤口pH值7.2±0.013,大肠埃希菌感染伤口pH值7.3±0.011。血液pH值及电解质在治疗前后均无显著变化。碳酸氢钠治疗组住院治疗时间及创口愈合时间明显短于普通治疗组(P<0.05)。结论碳酸氢钠可以促进骨折感染伤口与骨折的愈合,缩短住院时间,有一定应用价值。

Clinical study on sodium bicarbonate in treatment of open-fracture tibia with infection

Objective To explore the effective of sodium bicarbonate in treatment of open -fracture tibia with infection. Methods The patients with open -fracture and infection of tibia were divided into two groups randomly. The conventional group was treated with bone fracture replacement, washing infected wound, and anti-infective thera-py. The sodium bicarbonate group was treated with sodium bicarbonate intervenous drop＂ infusion and washing infected wound, pH and bacteria type of wound exudate were detected before treatment, and the changes of pH of blood and electrolyte were detected before and after treatment. Results The wound was infected mainly by pseudomonas aeruginosa,followed by E. coli. pH was 7. 2 q-0. 013 in the pseudomonas aeruginosa infected wound and pH was 7.3_＋0. 011 in E. coli infected wound, pH and electrolytes in the blood had no significant changes before and after treatment. The hospitalization time and wound healing time in sodium bicarbonate treated group were significantly shorter than those of. conventional therapy group. Conclusion Sodium bicarbonate can promote the healing of infected wound in open fractures and fracture, and shorten hospital stay. It is an effective treatment.