抗生素骨水泥占位器在治疗慢性骨髓炎中的应用

目的探讨应用抗生素骨水泥占位器治疗慢性骨髓炎的临床疗效。方法回顾性分析2010年7月—2013年3月应用抗生素骨水泥占位器治疗慢性骨髓炎37例,男31例,女6例,年龄21~65(42.7±6.2)岁。清创前后均行细菌培养及药敏试验,根据结果指导全身应用敏感抗生素及相应类型抗生素骨水泥占位器。待感染控制后,取出抗生素骨水泥占位器,局部植骨治疗及更换内固定,直接缝合创口或行皮瓣移植。结果本组31例患者获得随访,6例患者失访,随访时间为9~24(17.2±2.3)个月。所有患者均应用2次抗生素骨水泥占位器,植骨愈合良好,其中27例重新植入内固定,29例行皮瓣移植覆盖创口,8例直接缝合创口。所有创口均愈合良好,局部无明显炎症复发迹象。结论应用抗生素骨水泥占位器治疗慢性骨髓炎是一种简单而有效的方法。

Application of antibiotic-loaded bone cement spacer to treatment of chronic osteomyelitis

Objective To investigate the treatment effect of antibiotic-loaded bone cement spacer on chronic osteomyelitis. Methods A retrospective analysis was performed on a group of 37 patients （31 males, 6 females） with chronic osteomyelitis, who were treated from July 2010 to March 2013. Their age was 21 - 65 （42.7± 6.2） years. Germiculture and drug sensitive test were made before and after debridement. According to the result, sensitive antibiotics and antibiotic-loaded bone cement spacer were applied. After the infection was controlled, antibiotic-loaded bone cement spacer was taken out and bone grafting was performed. At the same time, internal fixation was renewed. At last, the wound was sewed up or skin flap was transplanted. Results As a result, 31 patients were followed up successfully with a period of 9 -24 （17.2 ±2.3） months, and the other 6 ones were lost. All the patients made use of antibiotic-loaded bone cement spacer twice. Among them, 27 patients renewed internal fixation, 29 patients received skin flap transplantation, and 8 patients got direct wound suture. All the patients were healed without obviously recurrent inflammation. Conclusion Application of antibiotic-loaded bone cement spacer is simple and effective on chronic osteomyelitis.