摘要
目的探讨关节镜下交叉韧带重建术中应用万古霉素和庆大霉素浸泡、洗涤和保湿肌腱移植物的抗感染效果差异,为抗感染药物的选择与优化提供科学依据。方法857例进行交叉韧带重建术治疗的患者,根据术中药物浸泡与洗涤、保湿方法不同分为庆大霉素组(597例)和万古霉素组(260例)。庆大霉素组采取庆大霉素对肌腱移植物进行浸泡与洗涤、保湿,万古霉素组采取万古霉素对肌腱移植物进行浸泡与洗涤、保湿。比较两组患者术后关节感染率;不同年资术者治疗后关节感染率。结果庆大霉素组术后发生关节感染35例,万古霉素组术后发生关节感染6例;庆大霉素组术后关节感染率5.86%显著高于万古霉素组的2.31%,差异具有统计学意义(P<0.05)。高年资术者手术治疗庆大霉素组患者术后关节感染率为2.68%,高于低年资术者治疗万古霉素组的1.15%,但差异无统计学意义(P>0.05)。低年资术者手术治疗庆大霉素组患者术后关节感染率为8.21%,高于低年资术者治疗万古霉素组的2.31%,差异具有统计学意义(P<0.05)。结论术中用万古霉素比使用庆大霉素浸泡、洗涤和保湿肌腱移植物可以更有效降低关节镜下交叉韧带重建术后关节感染率。低年资术者手术时使用万古霉素浸泡对降低移植肌腱长时间暴露所带来的术后感染效果更明显。
Objective To discuss the difference in anti-infection effect of vancomycin and gentamicin immersion,washing and moisturizing tendon grafts during arthroscopic cruciate ligament reconstruction,so as to provide a scientific basis for the selection and optimization of anti-infective drugs.Methods A total of 857 patients undergoing cruciate ligament reconstruction were divided into gentamicin group(597 cases)and vancomycin group(260 cases)according to the different methods of immersion,washing and moisturizing during surgery.The gentamicin group took gentamicin to soak,wash and moisturize the tendon graft,and the vancomycin group took vancomycin to soak,wash and moisturize the tendon graft.Comparison was made on postoperative joint infection rate between the two groups,and the joint infection rate of surgeon with different years of treatment.Results There were 35 cases of joint infection in gentamicin group and 6 cases in vancomycin group.The joint infection rate of gentamicin group 5.86%was significantly higher than that of vancomycin group 2.31%,and the difference was statistically significant(P<0.05).The joint infection rate of senior surgeon in gentamicin group was 2.68%,which was higher than that of vancomycin group 1.15%,but the difference was statistically significant(P>0.05).The joint infection rate of senior surgeon in gentamicin group was 8.21%,which was higher than that of vancomycin group 2.31%,and the difference was statistically significant(P<0.05).Conclusion Compared with gentamicin,vancomycin immersion,washing and moisturizing tendon grafts can effectively lower the joint infection rate during arthroscopic cruciate ligament reconstruction.For junior surgeon,vancomycin soaking can significantly reduce postoperative infections caused by long-term exposure of transplanted tendons.
作者
黄小梅
刘礼初
赵立连
邢基斯
何利雷
王昌兵
刘效仿
HUANG Xiao-mei;LIU Li-chu;ZHAO Li-lian(Clinical Pharmacy Office,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)
出处
《中国实用医药》
2020年第17期117-119,共3页
China Practical Medicine
基金
佛山市高校与医院科研基础平台项目(项目编号:2017AG100041)
佛山市军民融合及可持续发展科技项目(项目编号:2018AG100091)。
关键词
交叉韧带重建
万古霉素
庆大霉素
感染
Cruciate ligament reconstruction
Vancomycin
Gentamicin
Infection
