封闭式负压引流技术与开放植骨对胫骨创伤性骨髓炎的应用实效性评价

目的 观察并探讨封闭式负压引流术(vacuum sealing drainage,VSD)与开放植骨治疗胫骨创伤性骨髓炎(tibial traumatic osteomyelitis,TTO)的有效性。 方法 选择2012年6月-2016年3月在浙江萧山医院接受治疗的TTO患者96例,将患者随机分为观察组和对照组2组,各48例。观察组接受VSD+开放植骨治疗;而对照组先控制感染、修复创面,3~6个月后行二期植骨治疗。统计2组患者的感染控制时间、肉芽覆盖时间、骨折愈合时间,评估2组综合疗效,并统计并发症发生情况。 结果 观察组感染控制时间、肉芽覆盖时间、骨折愈合时间分别为(13.2±1.7) d、(32.2±7.4) d和(6.3±1.6)个月,对照组为(20.7±2.2) d、(48.8±8.1) d和(8.7±2.0)个月,观察组感染控制时间、肉芽覆盖时间、骨折愈合时间均明显短于对照组(P<0.05);观察组有效率为91.7%(44/48),对照组为77.0%(37/48),观察组有效率明显高于对照组(P<0.05);观察组并发症发生率为6.3%(3/48),对照组为8.3%(4/48),2组并发症发生率相比,差异不具有统计学意义(P>0.05)。 结论 VSD联合开放植骨对TTO治疗效果显著,且能明显肉芽覆盖时间和骨折愈合时间,值得在临床上进一步推广。 

Efficacy evaluation of vacuum sealing drainage combined with open bone grafting for tibial traumatic osteomyelitis

Objective To observe the efficacy of vacuum sealing drainage (VSD) combined with open bone grafting for tibial traumatic osteomyelitis (TTO). Methods A total of 96 TTO patients in Xiaoshan hospital from June,2012 to March,2016 was selected,and the patients were randomly divided into observation group and control group,each with 48 cases.The observation group were treated with VSD combined with open bone grafting;while the control group were treated first with infection control and wound repair,and then treated by second-stage bone grafting after 3-6 months.Time of infection control,covering the granulation time,fracture healing time as well as comprehensive efficacy were evaluated and complications were observed and compared between the two groups. Results Time of infection control,covering the granulation time,fracture healing time was (13.2±1.7) g,(32.2±7.4) d and (6.3±1.6) months in observation group,while the control group was (20.7±2.2) d,(48.8±8.1) d and (8.7±2.0) months.Time of infection control,covering the granulation time,fracture healing time was significantly less in observation group than the control group (P<0.05);the efficient rate was 91.7%(44/48) in observation group,while 77.0%(37/48) in the control group.The observation group was significantly higher (P<0.05);complication rate in observation group was 6.3%(3/48),while in the control group was 8.3%(4/48).The difference was not statistically significant (P>0.05). Conclusion VSD combined with open graft on the TTO has significant effect,and can cover significantly granulation time and fracture healing time,worthy of further promotion in clinical practice.