【摘要】 目的:探讨病损切除联合载抗生素吉莱骨粉治疗儿童血源性胫骨骨髓炎的疗效；方法:回顾性分析2018年1月至2023年12月，我院采用病损切除联合载抗生素吉莱骨粉治疗的儿童血源性胫骨骨髓炎35例儿童，记录手术时间、感染控制情况、有无感染复发及并发症情况，感染区域骨质修复情况，术后患者红细胞沉降率(ESR)、白细胞(WBC)和C-反应蛋白(CRP)及末次随访采用视觉模拟量表(VAS)评分。结果:35例患者均顺利进行手术，手术时间为54～124 min。所有患者均获随访，时间为6～12个月。术后患者红细胞沉降率(ESR)、白细胞(WBC)和C-反应蛋白(CRP)、VAS评分等指标均较术前降低，差异有统计学意义(P<0.05)。术后2周伤口拆线时患部肿痛基本消失，手术切口愈合良好。1例患者感染复发，经再次病损切除联合载抗生素吉莱骨粉治疗后治愈，术后患者感染复发率为1/35。术后3个月复查X线片可见载抗生素可吸收人工骨填充区域已有骨痂形成，骨缺损区骨质生长良好。结论:病损切除联合载抗生素吉莱骨粉治疗儿童血源性骨髓炎可有效控制感染，保留骨骼的外形与功能，术后感染复发率低，手术操作简单，且无严重并发症，值得临床推广应用。更多还原

【Abstract】 Objective:To investigate the efficacy of lesion debridement combined with antibiotic-loaded Geli bone powder in treating pediatric hematogenous tibial osteomyelitis. Methods:A retrospective analysis was conducted on 35 pediatric patients with hematogenous tibial osteomyelitis treated at our hospital from January 2018 to December 2023 using debridement combined with antibiotic-loaded Geli bone powder. Surgical duration, infection control, recurrence, complications, bone repair at the infected site, postoperative erythrocyte sedimentation rate(ESR), white blood cell count(WBC), C-reactive protein(CRP), and visual analog scale(VAS) scores at final follow-up were recorded. Results:All 35 patients successfully underwent surgery, with operation times ranging from 54 to 124 minutes. All patients were followed up for 6 to 12 months. Postoperative levels of ESR, WBC, CRP, and VAS scores were significantly lower than preoperative levels(P<0. 05). By two weeks postoperatively, local swelling and pain had nearly disappeared, and surgical incisionshealed well. One patient experienced infection recurrence and was successfully cured after repeat debridementand implantation of antibiotic-loaded Geli bone powder, resulting in a postoperative infection recurrence rate of 1/35. At the 3-month follow-up, X-rays showed callus formation in the area filled with the antibiotic-loaded absorbable artificial bone, with good bone regeneration in the defect region.Conclusion: Debridementcombined with antibiotic-loaded Geli bone powder is effective for treating pediatric hematogenous osteomyeli-tis, achieving reliable infection control, preserving skeletal shape and function, and exhibiting a low infectionrecurrence rate and no severe complications. The procedure is straightforward and merits clinical promotion.更多还原