髋膝人工关节置换术后感染保留假体的清创治疗  

Prosthesis Retention Therapy for Postoperative Infection After Hip or Knee Arthroplasty

作　　者：朱建伟[1] 杨静[1] 沈彬[1] 周宗科[1] 康鹏德[1] 裴福兴[1] 

机构地区：[1]四川大学华西医院骨科,四川省成都市610041

出　　处：《中国骨与关节损伤杂志》2011年第4期313-315,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨人工髋、膝关节置换术后感染保留假体清创治疗的指征及注意事项。方法回顾性分析自2004～2009年收治的7例髋、膝关节置换术后感染（髋3例，膝4例），经术前诊断、评估，行清创加术后抗生素抗感染的保留假体治疗，分析成功、失败原因。结果7例中5例保留了假体，随访5～72个月，平均24.8个月，感染均无复发。2例治疗失败，行感染：二期翻修术，平均随访4．75年，感染无复发。结论保留假体的清创术结合持续冲洗在髋、膝关节置换术后感染的治疗中有一定的使刚价值，但应把握时机、掌握指证、采取合理的治疗措施。Objective To probe indications and cautions of prosthesis retention therapy for postoperative infection after hip or knee arthroplasty.Methods A retrospective study was conducted by collecting data fi＇om 7 patients between 2004 and 2009 for postarthroplas- tic infection and treated with prosthesis retention subsequent to routine debridement and antibiotics treatment. Out of the 7 patients, 3 received hip arthroplasly while lhe others underwent knee arthroplasty. By describing the courses from diagnosis and preoperative assessment to implementation of proposed interventions, the factors responsible for success and failure were analyzed.Results Five cases gained favorable outcomes and lived without reinfection at a mean follow-up for 5-72 months,24.8 months on average; while the other 2 cases re- ceived two-stage re-implantation for failure of retention treatment were with no evidence of reinfcetion at a mean follow-up for 4.75 years on average.Conclusion Prosthesis retention combined with debridenment and antibiotics has certain practical values in treating patients with hip or knee postarthroplastic infection. However, outcomes of this strategy mainly rely on mastery of indications, therapeutic time and specific cautions.

关 键 词：关节置换术 清创 保留假体 感染 

分 类 号：R619.3[医药卫生—外科学]