中西医结合治疗急性化脓性骨髓炎

目的：探讨急性化脓性骨髓炎的早期诊断及治疗方法。方法：回顾分析2008年3月～2010年11月经我科诊治的24例急性化脓性骨髓炎患者,女15例,男9例,年龄2岁～14岁,平均7.6岁,均有致病诱因,均有不同程度的疼痛、皮肤改变和功能受限,其中股骨下段17例,胫骨上段8例,均为单侧一处发病,均未累计相邻关节腔,WBC和ESR均升高,X线均未发现骨质异常,MRI均提示早期骨髓炎表现,局部分层穿刺阳性20例,细菌培养阳性20例,均行开窗减压术和持续引流,同时予以内服中药黄连解毒汤,术后应用抗生素2～4周。结果：所有患者的疼痛症状和活动障碍均消失,均痊愈,随访6个月,无一例复发。结论：依据诱因、症状、辅助检查早期明确诊断;及时开窗减压和持续引流,并应用敏感抗生素及中药治疗,避免细菌扩散或者蔓延为慢性。

Treating acute purulent osteomyelitis in the integrative medicine

Objective：To explore early diagnosis and treatment methods of acute purulent osteomyelitis.Methods：Retrospect and analysis 24 cases of acute purulent osteomyelitis patients from March 2008 to November 2010 in our hospital,in which,15 females,males 9 from 2 years to 14 years for average 7.6 years.These patients all had pathogen,varying degrees of pain,skin changes and limited function,in which,17 cases of distal femur,tibia 8 cases,which all belong to incidence in unilateral,not hurt adjacent joint cavity,WBC and ESR were elevated,X-ray bone were not found abnormalities,MRI suggested early performance of osteomyelitis.Local stratification puncture 20 cases of positive,20 cases of positive bacterial culture,which all applying Kaichuang decompression surgery and continuous drainage,at the same time,oral TCM HJD,postoperative antibiotics 2 to 4 weeks.Results：Pain and movement disorder of all patients were disappeared and cured,followed up for 6 months,no recurrence.Conclusion：We should according to pathogen,symptoms and secondary examinations to determine the condition,and we also should Kaichuang decompression surgery and continuous drainage,and applying sensitive antibiotics plus TCM to avoid the spread of germs or chronic spread.