游离皮瓣移植联合骨段滑移治疗胫骨骨髓炎骨缺损的临床观察

摘要

Objective To observe the clinical efficacy of free flap transplantation combined with bone segmental slipping for bone defect and tibial osteomyelitis.Methods A total of 72 cases of bone defect and tibial osteomyelitis were randomly divided into observation group and control group,with 36 cases in each group. The observation group was treated with free flap transplantation combined with bone segmental slipping,and the control group was treated with traditional staging operation.After 3 months of treatment,the knee joint evaluation system and the ankle joint function evaluation system were used to evaluate the function of lower extremities in the two groups, and postoperative pain was evaluated using McGee Pain Questionnaire.After 2 years of follow-up,the recurrence rate of tibial osteomyelitis was compared between the two groups.Results After 3 months of treatment,the scores of knee function and ankle function in the two groups were all higher than those before treatment,and the two scores in the observation group were all higher than those in the control group(P<0.05).The scores of each item of McGee Pain Questionnaire in the observation group were superior to those in the control group (P<0.05).After 2 years of follow-up,the recurrence rate of tibial osteomyelitis in the observation group was lower than that in the control group(P<0.05).Conclusion Free flap transplantation combined with bone segmental slipping is conducive to early recovery of knee and ankle function,relieve patients′pain and reduce the recurrence rate of tibial osteomyelitis in the trestment of bone defect and tibial osteomyelitis.%目的 观察游离皮瓣移植联合骨段滑移治疗胫骨骨髓炎骨缺损的临床疗效.方法 将72例胫骨骨髓炎骨缺损患者随机分为观察组与对照组,每组36例.观察组给予游离皮瓣移植联合骨段滑移治疗,对照组给予传统分期手术治疗.治疗3个月后采用膝关节评价系统及踝关节功能评价系统评价两组患者下肢功能,采用McGill疼痛问卷表评价患者术后疼痛情况.术后随访2年,比较两组患者胫骨骨髓炎复发率.结果 治疗3个月后,两组患者膝关节功能及踝关节功能评分均高于治疗前,且观察组患者两项评分均高于对照组(P<0.05);观察组患者术后McGill疼痛问卷表的各项评分均优于对照组(P<0.05).术后2年,观察组患者胫骨骨髓炎复发率低于对照组(P<0.05).结论 采用游离皮瓣移植联合骨段滑移治疗胫骨骨髓炎骨缺损,利于患者膝、踝关节功能早日恢复,减轻患者痛苦,降低胫骨骨髓炎复发率.