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载药硫酸钙在儿童血源性骨髓炎治疗中的临床研究。

Clinical study of drug-loaded calcium sulfate in the treatment of hematogenous osteomyelitis in children.

机构信息

Department of Orthopedics, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

出版信息

BMC Musculoskelet Disord. 2023 Oct 17;24(1):822. doi: 10.1186/s12891-023-06948-z.

Abstract

BACKGROUND

At present, good results have been obtained in the treatment of hematogenous osteomyelitis(HO) in children by the use of drug-loaded calcium sulfate, but there are few clinical studies reported. The aim of this study was to investigate the clinical efficacy of radical debridement combined with drug-laden calcium sulphate antibiotics in paediatric haematogenous osteomyelitis.

METHODS

In this study, we retrospectively analyzed the clinical data of 15 cases of pediatric hematogenous osteomyelitis admitted to our hospital in recent years. A total of 15 pediatric patients with HO treated in our hospital from January 2018 to February 2022 were included for evaluation.

RESULTS

All 15 patients were treated with drug-laden calcium sulfate, and the antibiotic of choice was vancomycin in 14 cases and vancomycin combined with gentamicin in 1 case. The follow-up period ranged from 12 to 36 months, with a mean follow-up time of 24.73 months, and all children were treated with drug-laden calcium sulfate with satisfactory clinical outcomes. The results of serological examination showed that the preoperative white blood cell count level, C-reactive protein and erythrocyte sedimentation rate were higher than the postoperative ones, and the differences were statistically significant (P < 0.05).After the operation, referring to the treatment standard of McKee's osteomyelitis, 15 cases were cured without recurrence; According to the Lower Extremities Functional Scale, 12 cases were excellent, 2 cases were good and 1 case was moderate, with an excellent rate of 93.33%. Children with lower limb involvement could walk with full weight bearing, and gait was basically normal.

CONCLUSION

Drug-loaded calcium sulfate is a good therapeutic method for the treatment of hematogenous osteomyelitis in children, with a effect of reducing complications and reducing recurrence.

摘要

背景

目前,载药硫酸钙在儿童血源性骨髓炎(HO)的治疗中取得了良好的效果,但临床研究报道较少。本研究旨在探讨彻底清创术联合载药硫酸钙抗生素治疗儿童血源性骨髓炎的临床疗效。

方法

本研究回顾性分析了近年来我院收治的 15 例儿童血源性骨髓炎的临床资料。纳入我院 2018 年 1 月至 2022 年 2 月收治的 15 例儿童 HO 患者进行评估。

结果

15 例患者均采用载药硫酸钙治疗,其中 14 例选用万古霉素,1 例选用万古霉素联合庆大霉素。随访时间为 12 至 36 个月,平均随访时间为 24.73 个月,所有患儿均采用载药硫酸钙治疗,临床疗效满意。血清学检查结果显示,术前白细胞计数、C 反应蛋白和红细胞沉降率均高于术后,差异有统计学意义(P < 0.05)。术后参照 McKee 骨髓炎治疗标准,15 例均治愈,无复发;根据下肢功能评分,优 12 例,良 2 例,可 1 例,优良率 93.33%。下肢受累患儿可完全负重行走,步态基本正常。

结论

载药硫酸钙是治疗儿童血源性骨髓炎的一种较好的治疗方法,可降低并发症发生率,降低复发率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce45/10580590/7d0ef6d280cb/12891_2023_6948_Fig1_HTML.jpg

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