6月龄以下婴儿化脓性髋关节炎诊疗分析  

Early diagnosis and treatment of septic arthritis of hip in infants under 6 month old

作　　者：金斌[1] 孙军[1] 

机构地区：[1]安徽省立儿童医院骨科

出　　处：《临床小儿外科杂志》2015年第4期316-318,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨6月龄以内婴儿化脓性髋关节炎的诊断和治疗时机，以减少后遗症的发生。方法回顾性分析本院自2003年1月至2010年12月收治的年龄在6个月以内的化脓性髋关节炎患儿临床资料，共32例33髋，归纳分析其早期诊断、治疗方法与效果。结果32例术后平均随访2．1年，其中21例于起病1周内就诊并获确诊，急诊给予髋关节切开置管冲洗引流术，并静脉二联应用抗生素至体温正常后1周，再口服抗生素2周，予Pavlik吊带将患髋外展位固定4周，痊愈率达100％，随访无后遗症。11例12髋起病超过1周后就诊，确诊后按上述方法治疗，6例痊愈无后遗症，5例6髋遗留股骨头骺破坏，关节僵硬，其中1例双侧股骨头骺破坏吸收，造成病理性髋关节脱位。结论早期发现、早期诊断、早期手术及抗炎治疗是减少或避免婴儿化脓性髋关节炎发生严重后遗症的关键因素。早期诊治的时间节点是起病1周内。Objetive To explore the best diagnosis and treatment of septic arthritis of hip in infants under 6 month old, in order to reduce the incidence of complications. Methods Retrospective analyze the cases under 6 month old of septic arthritis of the hip in our hospital from January 2003 to December 2010, which have 32 patients （33 hips）, and summarize the methods of early diagnosis and treatment. Results There were 21 cases visited our hospital and had been diagnosed septic arthritis of the hip. We gave them emergent operation of hip incision drainage and catheter flushing, then two-antibiotic anti-infective therapy for 2 weeks, and two weeks of oral antibiotics, fixed the hip abduction with Pavlik harness for 4 weeks, we got the cure rate of 100%, without any sequelae after more than 1 year follow-up, l 1 patients with 12 hips were transferred to our hospital more than a week after the onset, underwent the same treatment after diagnosis. 6 cases recovered without sequelae, five cases left femoral head epiphyseal damage, joint stiffness, one example left bilateral femoral bone epiphyseal damage and absorption. Conclusions Early detection, early diagnosis, early surgery and anti-inflammatory treatment are the key factors to reduce or avoid severe sequelae of septic arthritis of the hip in infant. Perfect time of diagnosis and treatment is wthin 1 week of disease onset.

关 键 词：骨关节炎 髋 早期诊断 婴儿 

分 类 号：R726.8[医药卫生—儿科]