化脓性膝关节炎的临床治疗有效性研究  

Effectiveness of clinical treatment of suppurative arthritis

作　　者：杨骐宁[1] 姜丹生[1] 蔡鹏飞[1] 周勇伟[1] 潘志军[2] 

机构地区：[1]金华市中心医院骨科,浙江金华321000 [2]浙江大学医学院附属第二医院骨科,浙江杭州310000

出　　处：《中华医院感染学杂志》2014年第4期947-949,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生平台重点基金资助项目(2011ZDA011)

摘　　要：目的观察关节镜下清理加术后持续灌洗治疗化脓性膝关节炎的效果，为临床治疗化脓性膝关节炎提供依据。方法对2010年1月一2012年12月医院18例化脓性膝关节炎患者行关节镜下清理术，术后用生理盐水及庆大霉素灌洗引流1～2周；观察患者治疗期间恢复情况，并进行疗效评定，使用SPSS19．0软件进行统计分析；膝关节活动度、Neer评分采用t检验；P〈O．05为差异有统计学意义。结果所有患者术后2～5d体温恢复正常，4～7d白细胞计数恢复正常，13～19d血沉和C反应蛋白恢复正常；所有患者切口I期愈合，无窦道形成；平均治疗时间为14．9d；随访12个月，未出现复发病例；患者术后8周屈膝达（109．8±15．8）。，高于治疗前的（45．1士10．2）。，差异有统计学意义（P〈O．05）；患者治疗后Neer膝关节功能评分为（94．01土4．73）分，高于治疗前的（54．47土3．34）分，差异有统计学意义（P〈O．05）；Neer评分优8例、良9例、差1例，优良率为94．44％。结论关节镜下清理及术后持续灌洗治疗化脓性膝关节炎恢复快、优良率高，是较理想的治疗方法。OBJECTIVE To observe the effect of debridement under arthroscopy combined with postoperative persistent irrigation on treatment of suppurative arthritis so as to provide basis for the clinical treatment of suppurative arthritis. METHODS Totally 18 cases of suppurative arthritis, who underwent the debridement under arthroscopy in the hospital from Jan 2010 to Dec 2012, were enrolled in the study, then the subjects received the persistent irrigation drainage with normal saline and gentamicin for 1--2 weeks, the recovery of the subjects was observed and the clinical efficacy was evaluated; the statistical analysis was performed with the use of SPSS19.0 software the t--test was conduced for the activity of knee joint and scoring of Neer PO. 05 was defined as the statistical significance. RESULTS The body temperatures of all subjects resumed to normal at 2- 5 days after operation, the white blood cell counts （WBC） resumed to normal at 4--7 days after operation, and the erythrocyte sedimentation rate （ESR） and C-reactive protein resumed to normal at 13--19 days after operation. All the stage I incisions were healed without formation of sinus the mean treatment time was 14.9 days. The 12--month follow-up showed no cases of recurrence. The knee flexion reached up to 109. 8-/- 15. 8 8 weeks after the operation, higher than 45.1＋10.2 before the treatment, with statistical significance （P%0.05） the Neer score of the knee joint function was （94.01 ＋ 4.73）points after the treatment, higher than （54.47-1-3.34） points before the treatment, with the statistical significance（P%0.05） the Neer score showed that 8 cases were excellent, 9 cases good, 1 case poor, with the excellent and good rate of 94. 44. CONCLUSION The debridement under arthroscopy combined with postoperative persistent irrigation can achieve ideal effect on treatment of suppurative arthritis, with recovery rapid, the excellent and good rate high.

关 键 词：化脓性膝关节炎 关节镜 清理术 灌洗术 临床疗效 

分 类 号：R684.3[医药卫生—骨科学]