自拟壮骨活血补阳汤联合负压封闭冲洗引流治疗创伤性骨髓炎临床研究

目的 评价自拟壮骨活血补阳汤联合负压封闭冲洗引流治疗创伤性骨髓炎的临床疗效.方法 将符合入选标准的132例创伤性骨髓患者按随机数字表法分为2组,每组66例.对照组负压封闭冲洗引流治疗,研究组在对照组基础上联用自拟壮骨活血补阳汤.2组均治疗15d,随访6个月.观察患者骨折愈合时间、肉芽覆盖时间、平均住院时间、抗生素使用时间、负压引流时间及细菌培养阳性率,记录治疗期间并发症发生率及随访期间的复发率,评价临床疗效.结果 治疗后,研究组总有效率95.5%(63/66)比83.3%(55/66),χ2=5.114]高于对照组(P<0.05);骨折愈合时间(5.3±1.1)个月比(7.6±1.9)个月,t=-8.705]、肉芽覆盖时间(27.8±5.6)d比(35.1±6.4)d,t=-6.961]、平均住院时间(31.2±4.27)d比(39.24±5.11)d,t=-9.870]均短于对照组(P<0.05)、抗生素使用时间(8.9±2.0)d比(13.3±3.9)d,t=-8.152]、负压引流时间(13.6±3.3)d比(19.2±4.2)d,t=-8.744]均少于对照组(P<0.05)、细菌培养阳性率6.1%(4/66)d比18.2%(12/66),χ2=4.552]低于对照组(P<0.05).对照组并发症发生率18.2%(12/66)比4.6%(3/66),χ2=6.092]、复发率21.8%(12/55)比7.9(5/63),χ2=4.589]高于研究组(P<0.05).结论 自拟壮骨活血补阳汤联合负压封闭冲洗引流可有效缩短创伤性骨髓炎患者骨折愈合时间、肉芽覆盖时间、平均住院时间、抗生素使用时间、负压引流时间,降低菌培养阳性率,提高临床疗效.

Clinical research of Zhuanggu-Huoxue-Buyang decoction combined with negative pressure seal flushing drainage treatment for traumatic osteomyelitis

Objective To investigate the clinical curative effect of Zhuanggu-Huoxue-Buyang decoction combined with negative pressure seal flushing drainage treatment for traumatic osteomyelitis. Methods According to the random number method, 132 patients with traumatic marrow from June 2015 to June 2016 in our hospital were divided into the control group and research group with 66 cases in each group. The patients of control group were treated with negative pressure seal flushing drainage, and the patients of research group were given to Zhuanggu-Huoxue-Buyang decoction on the basis of control group.Both groups were treated for 15 days. The clinical effective rate and clinically relevant indicators were counted, which included fracture healing time, granulation, covering time, average length of hospital stay, antibiotic use time, the negative pressure drainage time and positive rate of bacteria. At the same time patients complications were observed during the treatment. In addition, the recurrence rate of two groups was in the following half a year.Results The clinical effective rate of patients in the research group 95.5% (63/66) vs. 83.3% (55/66), χ2=5.114]was significantly higher than control group(P<0.05).The fracture healing time of patients in research group(5.3 ±1.1 months vs.7.6 ±1.9 months,t=-8.705)was significantly lower than the control group(P<0.05). The granulation covering time of patients in research group (27.8 ± 5.6 d vs.35.1 ± 6.4 d,t=-6.961) was significantly lower than the control group (P<0.05). The average length of hospital stay of patients in research group (31.2 ± 4.3 d vs.39.2 ± 5.1 d,t=-9.870) was significantly lower than the control group (P<0.05). The antibiotic use time of patients in research group(8.9 ±2.0 d vs.13.3 ±3.9 d,t=-8.152)was significantly lower than the control group (P<0.05). The negative pressure drainage time of patients in research group (13.6 ± 3.3 d vs.19.2 ± 4.2 d,t=8.744)was significantly lower than the control group(P<0.05).The culture positive rate of patients in research group6.1%(4/66)d vs.18.2%(12/66),χ 2=4.552]was significantly lower than the control group(P<0.05).The rate of complications of patients in control group18.2%(12/66)vs.4.6%(3/66),χ 2=6.092] was significantly higher than the research group (P<0.05). The relapse rate of patients in control group 21.8% (12/55)vs.7.9%(5/63),χ 2=4.589]was significantly higher than the research group(P<0.05).Conclusions The Zhuanggu-Huoxue-Buyang decoction combined with negative pressure seal flushing drainage treatment improves clinical indicators and reduces the incidence of complications and the recurrence rate.