临床小儿外科杂志

目的观察持续冲洗结合负压封闭引流(VSD)治疗儿童急性血源性骨髓炎的临床疗效。方法选取本院自2006年1月至2013年2月间诊断为急性血源性骨髓炎,并且病原学培养阳性的22例手术治疗患者,分为观察组(VSD组)7例和对照组(传统手术组)15例,对两组患者的住院天数、体温恢复正常天数、换药次数、手术次数进行比较。结果观察组患者住院时间中位数为26(21～28)d,对照组为29(25～34)d,差异有统计学意义(Z=2.018,P=0.047)。观察组患者体温恢复正常时间中位数为11(9～13)d,对照组为15(13～19)d,差异有统计学意义(Z=2.834,P=0.003)。观察组患者换药次数中位数为1(0～1)次,对照组为4(3～6)次,差异有统计学意义(Z=3.556,P<0.000 1)。观察组患者手术次数中位数为1(1～2)次,对照组为2(2～3)次,差异有统计学意义(Z=3.082,P=0.003)。结论持续冲洗结合负压封闭引流(VSD)治疗儿童急性血源性骨髓炎效果理想,可以缩短康复时间、减少换药及手术次数,值得临床推广应用。

Objective To explore the clinical efficacy of vacuum sealing drainage(VSD)for pediatric acute hematogenous osteomyelitis. Methods From January 2006 to February 2013,22 surgical patients of acute hematogenous osteomyelitis with positive blood or pyogenic fluid culture test were enrolled. They were divided into observation(VSD,n=7)and control(conventional operation,n=15)groups. The length of hospitalization stay,time of normalizing temperature,times of dressing change and number of operations was compared for two groups. Results The median length of hospitalization stay was 26(21～28)days in observation group versus 29(25～34)days in control group. The inter-group difference was significant(Z=2.018,P=0.047). The median time of normalizing temperature was 11(9～13)days in observation group versus 15(13～19)days in control group. The inter-group difference was significant(Z=2.834,P=0.003). In observation group,the median times of dressing change was 1(0～1)times versus 4(3～6)times in control group. The inter-group difference was significant(Z=3.556,P=0.000). The median number of operations was 1(1～2)times in observation group versus 2(2～3)times in control group. The inter-group difference was significant(Z=3.082,P=0.003). Conclusion s Efficacious for pediatric acute hematogenous osteomyelitis,VSD may shorten recovery time and reduce the frequency of dressing change and operation. And it is worthy of wider clinical applications.

引言
1 材料与方法
2 结果
3 讨论

图1 女孩,10岁,起病2 d的X线片; 图2起病3 d的核磁共振结果; 图3钻孔引流; 图4骨皮质开窗; 图5安置VSD引流管; 图6生物透性薄膜密封; 图7术后2个月X线片<br/>Fig.1 Plain film of a 10-year-old girl with a 2-day onset; Fig. 2 MRI scan at Onset Day 3; Fig. 3 Drilling for irrigation; Fig. 4 Bone windowing; Fig. 5 Implanting VSD irrigation tube; Fig. 6 Sealing with a bio-permeable thin membrane; Fig. 7 Plain film at 2 months post-operation

图1 女孩,10岁,起病2 d的X线片; 图2起病3 d的核磁共振结果; 图3钻孔引流; 图4骨皮质开窗; 图5安置VSD引流管; 图6生物透性薄膜密封; 图7术后2个月X线片
Fig.1 Plain film of a 10-year-old girl with a 2-day onset; Fig. 2 MRI scan at Onset Day 3; Fig. 3 Drilling for irrigation; Fig. 4 Bone windowing; Fig. 5 Implanting VSD irrigation tube; Fig. 6 Sealing with a bio-permeable thin membrane; Fig. 7 Plain film at 2 months post-operation

表1 两组患者各项指标比较[M(P25～P75)]<br/>Table 1 Inter-group comparisons of clinical parameters[M(P25～P75)]

表1 两组患者各项指标比较[M(P25～P75)]
Table 1 Inter-group comparisons of clinical parameters[M(P25～P75)]

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备注

引言

1 材料与方法

2 结果

3 讨论

期刊信息

备注

引言

1 材料与方法

2 结 果

3 讨 论

期刊信息

2 结果

3 讨论