论文部分内容阅读
目的:探究哪种剂量青霉素在骨折模型制备过程中预防感染有效。方法建立新西兰大白兔股骨骨折模型,造模成功后依据青霉素剂量的不同将兔随机分为三组,A组术后左侧臀大肌肌注青霉素40万U,1次/d,连续3d,切口换药7d,1次/d;B组术后左侧臀大肌肌注青霉素40万单位,1次/d;C组术后左侧臀大肌肌注青霉素80万单位,1次/d,连续3d。术后4w对三组兔局部分层穿刺后作菌培养,抽血化验白细胞,麻醉后后行X线片检查。结果三组兔术后早期都可看到切口渗血,患肢跛行,食欲的减退,白细胞增高。A、B、C三组分别有2、11、2只X线表现出经典骨髓炎表现,为皮质破坏,边界不清,死骨形成影相,同时菌培养可见有菌落生长。A、B、C三组感染率分别为8%、44%、9%(表2)。三组间两两比较A组和B组比较<0.00417,两组有效率之间差异有统计学意义;B组和C组之间比较<0.00625两组有效率间差异有统计学意义;A组和C组比较两组跃0.0125差异未见统计学意义。结论青霉素40万单位,1次/d肌注连续3d加换药7d或80万单位,1次/d,连续3d不用换药均可有效控制感染,可用于指导兔骨折或骨不连模型的制备中的抗感染。“,”Objective To explore the effective prevention of infection in the process of preparing the fracture model with dose of penicillin. Methods To establish the New Zealand White rabbits femur fracture model and made successful model according to the dose of penicillin different rabbits were randomly divided into three groups, group A after the left gluteus maximus intramuscular penicillin 40 000 u, 1 times / day, for 3 consecutive days, dressing the wound for 7 days, 1 times/ day;group B after operation the left gluteus maximus muscle infusion of penicillin to 40 million U, 1 times/day; patients in group C after left gluteus maximus intramuscular penicillin 80 million U, 1 times / day for 3 consecutive days. 4 weeks after the operation of 3 groups of rabbits after partial layer puncture bacteria culture, blood tests of white blood cells, X-ray examinations were performed after anesthesia. Results The 3 groups after operation early can see the incision oozing, limp, decreased appetite, increased white blood cells. Group A, group B and group C respectively, 2, 11, 2 X-ray showed the classic manifestations of osteomyelitis, for the destruction of the cortex, border is not clear, the dead bone formation, images and bacteria culture can be seen, there is a colony growth. The infection rates of A, B and C were 8%, 44%, 9% (Table 2). Between the three groups, the difference between the two groups was statistically significant between P group and B group, the difference between the two groups was statistically significant; the difference between the B group and the C group was statistically significant; the difference between the A group and the P group was statistically significant between the two groups, the P group and the C group was not statistically significant. Conclusion Penicillin 40 000 u, 1 times / daily intramuscular injection of continuous 3 TICA dressing 7 days or 8 00000 u, 1 times /day, for 3 consecutive days without dressing can effective infection control and can be used in guidance of rabbit fracture or bone nonunion model preparation of anti infection.