论文部分内容阅读
对几丁糖庆大霉素局部药物释放系统治疗慢性骨髓炎的疗效及体内动力学行为进行研究，为其临床推广应用提供理论依据。采用外科病灶清除术后残腔内置入几丁糖庆大霉素缓释药治疗慢性骨髓炎１８例。监测术后不同时间庆大霉素血药浓度，血尿素氮（ＢＵＮ）和肌酐（Ｃｒ）值，局部引流液中庆大霉素浓度。以术后切口愈合情况、临床表现和Ｘ线片评定疗效。结果，血药浓度峰值（０．８３μｇ／ｍｌ）在２４小时出现，维持时间为４天；术后ＢＵＮ和Ｃｒ值无增加；术后局部引流液中庆大霉素浓度为金黄色葡萄球菌最低抑菌浓度数百倍。１８例患者均获随访，随访时间６个月～３４个月，平均２４．８个月。初期愈合１６例，无一例复发。认为，几丁糖庆大霉素缓释药是临床治疗慢性骨髓炎的有效方法，具有简便安全，且无需二期取出载体的优点，为临床推广应用提供了理论依据。
To study the curative effect and in vivo kinetics of chitin gentamicin-based local drug delivery system for treating chronic osteomyelitis, and to provide a theoretical basis for its clinical application. Chronic osteomyelitis was treated with gentamicin chitosan chitosan in 18 cases after surgical removal of the lesion. The concentration of gentamycin, blood urea nitrogen (BUN) and creatinine (Cr) were measured at different time points after gentamicin treatment. Postoperative incision healing, clinical manifestations and X-ray evaluation of curative effect. The results showed that peak plasma concentration (0.83μg / ml) appeared at 24 hours and maintained for 4 days. There was no increase in BUN and Cr after operation. The gentamicin concentration in local drainage fluid was the lowest for Staphylococcus aureus Bacteriostatic concentration hundreds of times. Eighteen patients were followed up for 6 months to 34 months with an average of 24.8 months. Initial healing in 16 cases, no case of recurrence. It is considered that the chitosan gentamicin sustained-release drug is an effective method for clinical treatment of chronic osteomyelitis and has the advantages of being simple and safe, without the need of removing the carrier in the second phase and providing a theoretical basis for clinical popularization and application.