骨水泥不同时相负载抗生素

背景:在人工关节置换中,骨水泥与何种抗生素配伍能起到有效预防和治疗置换后感染目前还存在争议。目的:观察抗生素骨水泥中不同抗生素及不同混合方法对动物体内抗生素释放特性以及骨水泥力学性能的影响。方法:36只大白兔随机抽签法分为6组,3个实验组在骨水泥固相与液相混合后分别加入2g硫酸庆大霉素、1g万古霉素、1.5g头孢呋辛钠,制成负载抗生素的骨水泥,置于实验兔体内。3个对照组分别在40g骨水泥固相与液相混合前加入2g硫酸庆大霉素粉剂、1g万古霉素粉剂、1.5g头孢呋辛钠。结果与结论:3种抗生素在兔体内持续平均释放时间均在31d以上,骨水泥固相与液相混合后加入抗生素的3组抗生素洗提总量分别高于混合前加入抗生素的3组(P<0.05),混合后加入万古霉素组的洗提总量高于其他各组(P<0.05)。各组抗生素骨水泥的力学性能均优于ISO5833国际标准,组间差异无显著性意义。提示抗生素能有效从骨水泥中释放,骨水泥中加入1.0～2.0g抗生素不影响骨水泥的机械强度;万古霉素的洗提效果较好;骨水泥固相与液相混合后加入抗生素的混合方法更有利于抗生素的释出。

Bone cement mixed with different antibiotics using different methods

BACKGROUND:In artificial joint replacement surgery,which antibiotic mixed with bone cement can play an effective prevention against postoperative infection is still controversial.OBJECTIVE:To study the release characteristics of antibiotic in animals and the mechanical properties of bone cement based on the observation of bone cement mixed with different antibiotics using different mixture methods.METHODS:Thirty-six white rabbits were randomly divided into six groups:gentamicin group Ⅰ,vancomycin group Ⅰ,cefuroxime sodium group Ⅰ,gentamicin group Ⅰ,vancomycin group Ⅰ,cefuroxime sodium group Ⅰ.In the former three groups,2 g of gentamicin sulfate,1 g of vancomycin and 1.5 g of cefuroxime sodium were added into 40 g of bone cement at different phases,respectively,to prepare antibiotic-loaded bone cements that were then implanted into the rabbits.In the latter three groups,2 g of gentamicin sulfate,1 g of vancomycin and 1.5 g of cefuroxime sodium were respectively added before the solid-phase and liquid-phase mixture of 40 g bone cement.RESULTS AND CONCLUSION:The average release time of three antibiotics was over 31 days in rabbits.The elution volume of antibiotics in the former three groups was higher than that in the latter three groups(P < 0.05).The elution volume in the vancomycin group Ⅰ was higher than that in the other groups(P < 0.05).The mechanical properties of antibiotic-loaded bone cements in each group were better than international standard ISO 5833,and there was no significant difference among the groups.These findings indicate that antibiotics can release from bone cement effectively;bone cements containing 1-2 g of antibiotics cannot affect the mechanical strength of bone cements;the elution effect of vancomycin is better;the method to add antibiotics after the solid-phase and liquid-phase bone cement mixture is more conducive to the release of antibiotics.