中药外治结合外科手术治疗胫骨创伤后骨髓炎骨质皮肤缺损.pdfVIP

.218. 中国骨伤 2008 年3 月第 21 卷第 3 期 China J Orthop Trauma. Mar.2008 •Vol.21 •No .3 ·经验来流· 中药外治结合外科手术治疗腔骨创伤后骨髓炎 骨质皮肤缺损 刘雪涛 1 ，张成进 1 ，李忠 1 ，范启申 1 ，王成琪 1 ，丁望 2 ，赵文海 3 (1.解放军的医院全军创伤骨科研究所二区，山东 海坊 261021 ;2.解放军的医院二十区;3. 长春中医学院附属医 院骨科) [摘要] 目的:探讨中药外治结合外科手术治疗腔骨创伤后骨髓炎骨质皮肤缺损的方法和疗效。方法:本组腔骨 创伤后骨髓炎骨质皮肤缺损 28 例，男 18 例，女 10 例;年龄 18-68 岁，平均 32.5 岁。采取外用中药换药，待创面感染控 制后取带血管榕骨皮瓣移植 I 期修复，随访治疗效果并进行分析。结果:28 例均获随访，时间 8-56 个月，平均 30 个 月。皮瓣全部成活，伤口 I 期愈合 26 例， 11 期愈合2 例。移植骨全部愈合，愈合时间 2-14 个月，平均 4.6 个月。骨髓炎 复发2 例，经二次病灶清除愈合。结论:外用中药换药结合外科手术治疗腔骨创伤后骨髓炎骨质皮肤缺损，能够有效 控制感染，一次性修复组织缺损，值得临床推广。 [关键词] 腔骨; 骨髓炎; 外治法: 中药疗法; 修补手术，外科 Chinese herbs application combined with operation for treating post-tramnatic tibialωteomyelitis complicated wi伽 bone-skin defects LlU Xue-tω* ,ZHANG Cheng-jin ,Ll Zhong ,FAN Qi-sh凹， WANG Cheng-qi ,DlNG Wang,ZHAO Wen- hai. *The 2nd Dep田tment ofO础。[J aedics ,the Whole Wound lnstitute of 89th Hospit a1 ofPLA , Weifang 261021 ,Shandong , China ABSTRACT Objective: The aim of this study was to explore the method and clinical effects of integration of Chinese herbs and operation for the treatment of post-traumatic tibial osteomyelitis complication with bone-skin defect. Methods: Among 28 patients with post-traumatic tibial osteomyelitis complicated with bone-skin defects , 18 patients were male and 10 females , ranging in age from 18 to 68 years ,with an average of 32.5 years. All the patients were treated with transplantation of free iliac flaps to one-stage repair the bone-skin defects after infection controlled with Chinese herbs dressing. The curative effects were analyzed. Results: All the patients were followed up and ranged from 8 to 56 months ,with an average of 30 months. All of the flap survived ,and the wounds got primary healing in 26 patien恒 and secondary healing in 2 patie