Objective To explore the effect of traditional incision and drainage combined with vacuum sealing drainage (VSD)in treating patients with purulent exudation-staged genual septic arthritis. Methods The patients with purulent exuda-tion-staged genual septic arthritis were selected in the Zhengzhou Orthopedics Hospital from January 2010 to December 2015, and they were divided into control group and observation group. Fifty-four patients in the control group were treated with open operative drainage,while fifty patients in the observation group were treated with open operative drainage combined with VSD. The operation time,intraoperative bleeding volume,tourniquet application time,washing time,antibiotic use time,hospitalization time,therapeutic effect and relapse rate were compared between the two groups. Results There was no statistical difference in operation time and tourniquet application time and intraoperative bleeding volume between the two groups(t = - 0. 216,2. 518, 11. 320;P > 0. 05). Compared with the control group,the antibiotic use time and hospitalization time were shorter,the washing time was longer in the observation group(t = 2. 270,- 46. 310,2. 518;P < 0. 05). The occurrence rate of postoperative compli-cations in the control group and the observation group was 9. 3％(5 / 54)and 6. 0％(3 / 50),there was no statistical difference in the occurrence rate of postoperative complications between the two groups(χ2 = 0. 331,P > 0. 05). The fineness rate in the control group and the observation group was 25. 9％(14 / 54)and 22. 0％(11 / 50),there was no statistical difference in the fineness rate between the two groups(χ2 = 0. 219,P > 0. 05). The relapse rate in the control group and the observation group was 33. 3％(18 / 54)and 8. 0％(4 / 50),the relapse rate in the observation group was lower than that in the control group (χ2 =0. 331,P <0. 05). Conclusion Traitional incision and drainage combined with VSD has advantages of shortening hospital-ization and intravenous antibiotic time and decreasing relapse rate in treating purulent exudation-staged genual septic arthritis.%目的 探讨传统切开引流术联合负压封闭引流(VSD)治疗成人脓性渗出期化脓性膝关节炎的临床疗效.方法 将郑州市骨科医院2010年1月至2015年12月收治的104例成人脓性渗出期化脓性膝关节炎患者分为对照组(n=54)和观察组(n=50).对照组患者给予传统切开冲洗引流术;观察组患者在对照组治疗的基础上行VSD术.比较2组患者手术时间、术中失血量、止血带应用时间、关节冲洗时间、静脉抗生素使用时间、住院时间、治疗效果及复发率.结果 2组患者手术时间、止血带应用时间、术中失血量比较差异无统计学意义(t=-0.216、2.518、11.320,P>0.05);与对照组比较,观察组患者静脉抗生素使用时间、住院时间短,关节冲洗时间长(t=2.270、-46.310、2.518,P<0.05).对照组和观察组患者术后并发症发生率分别为9.3％(5/54)和6.0％(3/50),2组患者术后并发症发生率比较差异无统计学意义(χ2=0.331,P>0.05).对照组和观察组患者治疗优良率分别为25.9％(14/54)和22.0％(11/50),2组患者治疗优良率比较差异无统计学意义(χ2=0.219,P>0.05).对照组和观察组患者复发率分别为33.3％(18/54)和8.0％(4/50),观察组患者复发率显著低于对照组(χ2=0.331,P<0.05).结论 传统切开引流术联合VSD治疗成人脓性渗出期化脓性膝关节炎具有住院时间和静脉抗生素使用时间短、复发率低等优点.
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