抗生素骨水泥占位器在全髋关节置换感染Ⅱ期翻修中的应用  

Use of antibiotic bone cement spacer in treatment of the postoperative infection in the two stage revision of artificial hip arthroplasty

作　　者：陈波[1] 杜远立[1] 梁杰[1] 茹能[1] 武斌[1] 

机构地区：[1]三峡大学人民医院骨科,湖北宜昌443000

出　　处：《中国实用医刊》2012年第9期56-58,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨采用抗生素骨水泥占位器二期翻修治疗人工髋关节感染的疗效。方法自2004年5月至2010年12月，15例初次髋关节置换术后感染患者行二期翻修手术。一期手术中取出假体并彻底清创，放置抗生素骨水泥占位器，术后静脉输入抗生素3周后改为口服抗生素4周。二期置换手术于4—6个月后进行。其中髋关节功能采用Harris评分进行评价。结果15例患者均获得随访，随访时间8—36个月。所有患者伤口均一期愈合，感染无复发。术后Harris评分较术前明显提高（85±8vs42±7，P〈0．05）。结论彻底清创、应用抗生素骨水泥占位器能够有效控制感染复发和提高二期置换手术效果。Objective To investigate the efficacy of antibiotic bone cement spacer on postopera- tive infection of artificial hip arthroplasty. Methods From May 2004 to December 2010, 15 patients suffered from infection after primary hip arthroplasty were performed with revision surgery. First step to remove the prosthesis and do debridement, then antibiotic bone cement spacer was placed in the joint. After the operation patients were treated with intravenous antibiotics for 3 weeks, then changed to oral antibiotics for 4 weeks. Second step the revision surgery was done after 4-6 months. Harris hip score was used for evaluation. Results Fifteen patients were followed up for 8 to 36 months. The wounds healed well of all patients and without infection recurrence. Postoperative Harris hip score（ 85 ±8） improved significantly compared with the preoperative score（42 ±7 ） （ P 〈 0.05 ）. Conclusions The debridement and using the antibiotic bone cement spacer was able to effectively control the infection recurrence and improve the efficacy of the revision surgery on infection in artificial hip arthroplasty.

关 键 词：关节置换 感染 翻修术 抗生素骨水泥占位器 

分 类 号：R687.4[医药卫生—骨科学]