發(fā)布時(shí)間：2019-05-22 16:47

【摘要】：目的： 比較Ilizarov骨搬運(yùn)技術(shù)與鋼板結(jié)合骨移植在治療長(zhǎng)管狀骨感染性骨不連的臨床療效，為長(zhǎng)管狀骨感染性骨不連手術(shù)治療方式的選擇提供依據(jù)及參考。 方法： 隨訪吉大一院創(chuàng)傷骨科在2010年7月至2014年10月期間收治感染性骨不連患者19例,其中男13例，女6例；年齡24～58歲；病程8～30個(gè)月；隨訪時(shí)間12～22個(gè)月。車禍傷13例，摔傷2例，，重物砸傷2例，高處墜落傷2例。脛骨10例，股骨9例。對(duì)這19例患者根據(jù)手術(shù)方式的不同進(jìn)行分組:應(yīng)用Ilizarov骨搬運(yùn)技術(shù)orthfix單臂外固定架治療（實(shí)驗(yàn)組）8例；應(yīng)用鎖定加壓鋼板（LCP）結(jié)合自體骨移植植骨治療（對(duì)照組）11例。對(duì)兩組患者進(jìn)行隨訪，并對(duì)收集的資料進(jìn)行回顧性分析。通過病歷記錄、電話隨訪及門診隨訪統(tǒng)計(jì)患者信息，并對(duì)信息進(jìn)行評(píng)估分析。主要觀察指標(biāo)：住院天數(shù)、術(shù)中累積失血量、部分負(fù)重時(shí)間、感染控制率、住院費(fèi)用、再手術(shù)率、骨缺損程度、平均手術(shù)次數(shù)、AAOS評(píng)分。數(shù)據(jù)應(yīng)用SPSS17.0進(jìn)行分析處理。 結(jié)果： 實(shí)驗(yàn)組患者住院天數(shù)、術(shù)中累積失血量、部分負(fù)重時(shí)間、感染控制率、住院費(fèi)用、再手術(shù)率、骨缺損程度、平均手術(shù)次數(shù)、AAOS評(píng)分分別為35.25±9.57d、1348.12±226.05ml、1.91±0.36m、87.5％、70795.87±20385.53RMB、0％、4.50±1.41cm、3.00±1.07次、84.75±1.67；對(duì)照組為48.27.40±16.45d、2465.45±666.31ml、2.78±0.58m、72.7％、90204.89±25359.46RMB、27.3％、2.55±1.75cm、4.36±1.57次、80.45±3.30。兩組比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。實(shí)驗(yàn)組在以上方面優(yōu)于對(duì)照組。 結(jié)論： 1.Ilizarov骨搬運(yùn)技術(shù)治療長(zhǎng)管狀骨感染性骨不連療效顯著，感染控制率高。 2.Ilizarov骨搬運(yùn)技術(shù)對(duì)于軟組織條件要求較低，能夠有效保護(hù)軟組織，促進(jìn)其恢復(fù),為肢體恢復(fù)長(zhǎng)度提供保障。 3.實(shí)驗(yàn)組病例數(shù)較少，需繼續(xù)完善統(tǒng)計(jì)學(xué)資料，進(jìn)行進(jìn)一步研究。
[Abstract]:Objective: to compare the clinical efficacy of Ilizarov bone handling technique and plate combined bone transplantation in the treatment of long tubular bone infectious nonunion, and to provide basis and reference for the choice of surgical treatment of long tubular bone infectious nonunion. Methods: from July 2010 to October 2014, 19 patients with infectious nonunion were followed up in the Department of Trauma Orthopaedics, Jida Hospital, including 13 males and 6 females, aged 24 years and 58 years, the course of disease was 8 times 30 months, and the follow-up time was 12 months and 22 months. There were 13 cases of car accident injury, 2 cases of fall injury, 2 cases of heavy object injury and 2 cases of falling injury. There were 10 cases of tibia and 9 cases of femurs. The 19 patients were divided into two groups according to the different surgical methods: 8 cases were treated with Ilizarov bone transport technique orthfix single arm external fixation (experimental group), 11 cases were treated with locking compression plate (LCP) combined with autologous bone grafting (control group). The patients in the two groups were followed up and the collected data were analyzed retrospectively. The patient information was counted by medical record, telephone follow-up and outpatient follow-up, and the information was evaluated and analyzed. Main outcome measures: hospitalization days, cumulative blood loss during operation, partial load-bearing time, infection control rate, hospitalization expenses, reoperation rate, bone defect degree, average operation times, AAOS score. The data are analyzed and processed by SPSS17.0. Results: in the experimental group, the hospitalization days, cumulative blood loss, partial load time, infection control rate, hospitalization expenses, reoperation rate, bone defect degree, average operation frequency and AAOS score were 35.25 鹵9.57 days, respectively. 1348.12 鹵226.05ml, 1.91 鹵0.36m, 87.5%, 70795.87 鹵20385.53 RMB, 0%, 4.50 鹵1.41cm, 3.00 鹵1.07 times, 84.75 鹵1.67 times; The control group was 48.27.40 鹵16.45d, 2465.45 鹵666.31ml, 2.78 鹵0.58m, 72.7%, 90204.89 鹵25359.46, RMB 27.3%, 2.55 鹵1.75cm, 4.36 鹵1.57 times, 80.45 鹵3.30 times. There was significant difference between the two groups (P < 0.05). The experimental group was superior to the control group in the above aspects. Conclusion: 1.Ilizarov bone transport technique is effective in the treatment of infectious nonunion of long tubular bone, and the infection control rate is high. 2.Ilizarov bone transportation technology has low requirements for soft tissue conditions, which can effectively protect soft tissue, promote its recovery, and provide a guarantee for limb recovery length. 3. The number of cases in the experimental group is small, so it is necessary to continue to improve the statistical data and carry out further research.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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