硕士学位论文
扩大清创结合膜诱导技术治疗Cierny-Mader IV 型
骨髓炎临床疗效及影响因素研究*
吴宏日
猪耳朵的功效与作用
指导教师
赵金香谢 肇 教授 导师组成员 吴雪晖 侯天勇 罗飞 培养单位 第三军医大学第一附属医院骨科
申请学位类别 硕士专业学位 专业名称外科学（骨外）
论文提交日期 2017年5月 论文答辩日期
2017年6月 答辩委员会主席 罗卓荆 教授
西风的话简谱
加内特图片评 阅 人 邓忠良 教授 张峡 教授
二〇一七年五月 *分类号R681.2 密 级 公 开
泡妞秘籍学 号2002014353学校代码
90031
目 录
缩略语表 (1)
英文摘要 (2)
中文摘要 (5)
论文正文扩大清创结合膜诱导技术治疗Cierny-Mader IV型骨髓炎临床疗效及影响因素研究 (8)
第一章前言 (8)
第二章扩大清创结合膜诱导技术治疗Cierny-Mader IV型骨髓炎临床疗效及影响因素研究 (11)
1 资料及方法 (11)
2 统计学分析 (15)
3 结果 (16)
4 结论 (20)
5 讨论 (20)
全文总结 (24)关于读书的活动
参考文献 (25)
文献综述成人慢性骨髓炎Cierny-Mader分型及治疗进展 (29)
参考文献 (39)
攻读学位期间发表的论文 (45)
致谢 (46)
缩略语表
英文缩写英文全称中文译名
PMMA Polymethyl Methacrylate聚甲基丙烯酸甲酯
MRSA Methicillin-resistant -Staphylococcus aureus 耐甲氧西林金黄色葡萄球菌C-M Cierny-Mader 骨髓炎分型
LCP Locking Compression Plate 锁定加压钢板
Scale/Score 视觉模拟评分
Analogue
V AS Visual
Tomograghy 电子计算机断层扫描
CT Computed
MRI Nuclear Magnetic Resonance Imaging 核磁共振成像
一次函数练习题BMP Bone Morphogenetic Protein 骨形态发生蛋白
VEGF Vascular Endothelial Growth Factor 血管内皮生长因子
LEFS Lower Extremity Functional Scale 下肢功能量表
Cierny-Mader type IV osteomyelitis treated with aggressive debridement and induced membrane technique: clinical outcome and influencing factors rearch
Abstract
Background
百日祝福语Cierny-Mader (C-M) type IV chronic osteomyelitis reprents a complex clinical challenge with permeation of extensive bone and soft tissue involvement. Aggressive debridement through viable tissue margin includes en bloc rection improves the odds of eradication of infection, which creates challenging large bone and soft tissue loss in treating this type of osteomyelitis. This critical gmental bone defect typically management with distraction osteogenesis, vascularized bone grafts or permanent acrylic spacers after debridement. However, the techniques for reconstruction of significant bone loss are associated with lengthy healing and unpredictable complications, or they u methods that are complicated or poorly tolerated.The induced membrane (Masquelet) technique, involving the placement of a polymethylmethacrylate (PMMA)spacer in the defect with subquent bone grafting, has achieved good results in the management of large defects. The induced membrane is highly vascularized and cretes veral growth factors, including VEGF and BMP-2. Furthermore, extracts from the membrane have been shown to stimulate bone marrow cell proliferation and differentiation of progenitor cells to the osteoblast lineage. The factors combine to facilitate successful consolidation of simple cancellous bone graft within an induced membrane and prent length-independent in reconstructing gmental bone defect. The procedure potential as an
alternative reconstruction method for gmental bone defects due to type IV chronic osteomyelitis. And which was scarcely reported in literature. Apart from the biological advantages illustrated in literature, the antibiotic impregnated PMMA spacer may offers other advantages in treatment of post-osteomyelitis skeletal reconstruction, including therapeutic benefits eluting local adjuvant antibiotics and increa mechanical stable for fracture fixation and soft tissue healing. More over, considering the profile of vere infection and poor soft tissue, the impact on the treatment
