慢性骨髓炎的分期治疗策略

背景：慢性骨髓炎是骨科临床的疑难杂症之一,本文旨在探讨一种目前比较合理的治疗方式。目的：探讨运用灌洗负压引流和可吸收人工骨或者骨水泥混合抗生素分期治疗慢性骨髓炎的临床效果。方法：2008年3月至2012年3月采用一期清创灌洗负压引流,二期可吸收人工骨或者骨水泥混合抗生素植入治疗27例慢性骨髓炎患者,男21例,女6例;年龄20~77岁,平均38岁;骨髓炎发生部位：胫腓骨17例,股骨7例,跟骨3例。结果：27例患者均得到随访,随访时间6~51个月（平均27个月）,25例痊愈,2例复发。结论：一期清创、灌洗负压引流,二期可吸收人工骨或者骨水泥混合抗生素治疗慢性骨髓炎可以取得良好的临床疗效。

Staged treatment strategy for chronic osteomyelitis

Background： Chronic osteomyelitis is a difficult problem. The purpose of this article is to apply a proper method to solve it. Objective： The aim of the study is to explore the effects of application of debridement, irrigation and vacuum sealing drainage combined with implantation of calcium phosphate or cement impregnated with antibiotics in treatment of chronic osteomyelitis. Methods： From March 2008 to March 2012, 27 patients were treated by using debridement, wound irrigation and vacuum sealing drainage in the first stage, and implanted with calcium phosphate or cement loaded with antibiotics in the second stage. There were 21 males and 6 females with an average age of 38 years （range, 20 to 77 years）. Osteomyelitis occurred in tibia in 17 cases, in femur in 7 cases and calcaneus in 3 cases. Results： All the patients were followed up for 27 （6-51） months on average. Of them, 25 patients were cured , but the infection in 2 cases were unfortunately uncontrolled. Conclusions： Staged treatment by means of debridment, irrigation and VSD in the first stage, and implantation calcium phosphate or cement loaded with antibiotics in the second stage, is a effective method of chronic osteomyelitis.