探讨万古霉素硫酸钙联合超短波治疗创伤性骨髓炎临床疗效及安全性

目的: 探讨万古霉素硫酸钙联合超短波治疗创伤性骨髓炎临床疗效及安全性。方法: 74例创伤性骨髓炎患者随机分为对照组（37例）与试验组（37例），2组均给予常规治疗以及对症治疗，手术前3 d给予注射用盐酸去甲万古霉素0.8 g/d静滴，每日2次，选取硫酸钙骨移植替代物5～10 g与盐酸去甲万古霉素1 g加水调制成糊状，术后给予注射用盐酸去甲万古霉素0.8 g/d，每日2次，试验组术后联合超短波治疗，2组患者一个周期均为28 d，共治疗2个周期。比较2组临床疗效、治疗前后血液流变学指标、血清C 反应蛋白（CRP）、血清肿瘤坏死因子（TNF-α）、核因子-κB(NF-κB）以及不良反应发生情况。结果: 治疗后，对照组临床总有效率为78.38%，显著低于试验组的97.30% (P<0.05)。治疗后，试验组的红细胞聚集指数高于对照组（P<0.05），血浆粘度、全血粘度、红细胞沉降率（ESR）水平低于对照组（P<0.05）。试验组血清CRP、TNF-α、NF-κB水平显著低于对照组 (P<0.05)。对照组不良反应发生率为13.51%，试验组为8.11%，差异无统计学意义(P＞0.05)。结论: 万古霉素硫酸钙联合超短波治疗创伤性骨髓炎的临床疗效显著，安全性高。

Efficacy and safety of vancomycin calcium sulfate combined with ultrashort wave in the treatment of traumatic osteomyelitis

AIM: To evaluate the efficacy and safety of vancomycin calcium sulfate combined with ultrashort wave in the treatment of traumatic osteomyelitis. METHODS: Severty-four cases of traumatic osteomyelitis were randomly divided into control group and treatment group (37 cases each).The control group was given hydrochloric acid (0.8 g/d) for 3 days (2 times a day) before surgery.Selection of calcium sulfate bone graft substitute (5-10 g) and hydrochloric acid (1 g) were added to make paste. Hydrochloric acid (0.8 g/d) was given after the operation.The treatment group received ultra-short wave therapy after operation and all patients were treated for 28 days.The clinical effects, hemorheology index,the serum C- reactive protein (CRP), serum tumor necrosis factor (TNF-α),nuclear factor kappa B (NF-κB),and adverse reactions were compared between the two groups. RESULTS: After treatment, the total effective rate in the control group was (78.38%),which was significantly lower than that in the experimental group (97.30%) (P<0.05). After treatment, the erythrocyte aggregation index of the experimental group was higher than that of the control group (P<0.05).Plasma viscosity, whole blood viscosity and ESR level were lower than the control group(P<0.05).Levels of serum CRP,TNF-α and NF-κB in the experimental group were significantly lower than those in the control group (P<0.05).Levels of serum CRP,TNF-α and NF-κB were significantly lower than control group (P<0.05).The adverse reaction rate of control group was 13.51%,the treatment group was 8.11%,and the difference was not statistically significant (P> 0.05). CONCLUSION: Vancomycin calcium sulfate combined with ultrashort wave in the treatment of traumatic osteomyelitis is effective and safe.