Continuous irrigation and drainage combined with lesion debridement surgery for the treatment of purulent bone and joint infections in children
10.3760/cma.j.cn341190-20240312-00246
- VernacularTitle:持续灌洗引流联合病灶清除术治疗小儿骨关节化脓性感染的临床研究
- Author:
Zixiang LIU
1
;
Rongdan DAI
;
Haijia ZHU
;
Kai WANG
;
Haoran WANG
Author Information
1. 杭州市儿童医院骨科，杭州 310004
- Keywords:
Osteoarthritis;
Arthritis,infectious;
Therapeutic irrigation;
Drainage;
Leukocytes;
Interleukin-6;
C-reactive protein;
Child
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(8):1178-1182
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of continuous irrigation and drainage combined with lesion debridement surgery in the treatment of purulent bone and joint infections in children.Methods:A case-control study was conducted to retrospectively analyze the clinical data of 76 children with purulent bone and joint infections who received treatment at Hangzhou Children's Hospital from January 2021 to October 2022. Based on different treatment methods, these children were divided into a control group and an observation group, with 38 cases in each group. The control group received lesion debridement surgery, while the observation group underwent continuous irrigation and drainage combined with lesion debridement surgery. The clinical outcomes of the two groups were compared.Results:The total response rate in the observation group was 97.37% (37/38), which was significantly higher than that in the control group [76.32% (29/38), χ2 = 7.36, P < 0.05]. After treatment, the white blood cell count, erythrocyte sedimentation rate, and percentage of neutrophils in the observation group were (4.32 ± 0.95) × 10 9/L, (14.20 ± 2.50) mm/h, and (52.12 ± 8.45)%, respectively, all of which were significantly lower than those in the control group [(5.68 ± 1.02) × 10 9/L, (22.35 ± 3.35) mm/h, and (66.65 ± 6.20)%, t = 6.01, 12.01, 8.54, all P < 0.05]. The levels of interleukin-6, C-reactive protein, procalcitonin, and tumor necrosis factor-α in the observation group were (5.20 ± 1.02) ng/L, (8.20 ± 1.11) mg/L, (0.80 ± 0.12) μg/L, and (3.20 ± 1.02) ng/L, respectively, which were significantly lower than those in the control group [(8.12 ± 1.10) ng/L, (14.34 ± 2.20) mg/L, (1.12 ± 0.20) μg/L, and (7.50 ± 1.12) ng/L, t = 11.99, 15.36, 8.45, 17.49, all P < 0.05). At 1 week, 1 month, and 3 months after treatment, the Visual Analog Scale scores in the observation group were significantly lower than those in the control group ( t = 3.14, 2.33, 11.36, all P < 0.05). The recurrence rate in the observation group was significantly lower than that in the control group [2.63% (1/38) vs. 21.05% (8/38), χ2= 4.53, P < 0.05). Conclusion:Continuous irrigation and drainage combined with lesion debridement surgery is more effective for treating purulent bone and joint infections in children than lesion debridement surgery alone. This combined therapy can more effectively reduce inflammatory responses, alleviate pain, and lead to a lower recurrence rate.
