Haydon R C, Blaha J D, Mancinelli C, Koike K
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536.
Clin Orthop Relat Res. 1993 Oct(295):43-6.
Use of gentamicin-impregnated methylmethacrylate beads is a relatively new and effective method of treating osteomyelitis. Although previous studies have concluded that such therapy is associated with low systemic toxicity, no data are available relating the use of this treatment to ototoxicity and hearing loss. Audiometric thresholds from 28 cases of osteomyelitis treated by surgical debridement and long-term systemic antibiotics alone (14 subjects) or gentamicin-impregnated methylmethacrylate beads either alone or combined with systemic antibiotics (14 subjects) were analyzed. Results showed one permanent threshold shift in the gentamicin-impregnated methylmethacrylate beads group (8%) versus four permanent threshold shifts in the systemic antibiotics alone group (29%). Osteomyelitis patients treated with gentamicin-impregnated methylmethacrylate beads are at no more risk and are probably at less risk of experiencing ototoxicity than patients treated with conventional long-term systemic antibiotics.
使用庆大霉素浸渍的聚甲基丙烯酸甲酯珠是一种相对较新且有效的治疗骨髓炎的方法。尽管先前的研究得出结论，这种治疗方法全身毒性较低，但尚无关于这种治疗方法与耳毒性和听力损失相关的数据。分析了28例骨髓炎患者的听力阈值，其中14例仅接受手术清创和长期全身抗生素治疗，另外14例单独使用庆大霉素浸渍的聚甲基丙烯酸甲酯珠或联合全身抗生素治疗。结果显示，庆大霉素浸渍的聚甲基丙烯酸甲酯珠组有1例永久性阈值偏移（8%），而仅使用全身抗生素组有4例永久性阈值偏移（29%）。与接受传统长期全身抗生素治疗的患者相比，使用庆大霉素浸渍的聚甲基丙烯酸甲酯珠治疗的骨髓炎患者发生耳毒性的风险并不更高，甚至可能更低。
