关节镜清理联合局部应用万古霉素治疗17例膝关节革兰阳性菌感染疗效观察  

Clinical effect of arthroscopic debridement combined with topical application of vancomycin in the treatment of 17 cases of Gram-positive bacterial infection in knee joint

作　　者：方永刚[1] FANG Yonggang(Department of Orthopaedics, the Ninety-one Central Hospital of PLA, Jiaozuo 454003, Chin)

机构地区：[1]中国人民解放军第九十一中心医院骨科,河南焦作454003

出　　处：《上海医药》2017年第19期38-40,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:探讨关节镜下彻底清理联合关节内放置万古霉素治疗膝关节革兰阳性菌感染疗效。方法:回顾性分析膝关节革兰阳性菌感染患者17例,均采用关节镜清理结合关节内放置万古霉素进行治疗,一期闭合手术切口,术后不置管进行灌洗,配合术后康复锻炼综合治疗。结果:所有患者随访6~32个月,15例患者感染症状消失,2例患者进行了第2次关节镜手术,术后感染得到良好控制;在随访期间所有患者均无复发感染迹象。结论:关节镜下彻底清理联合关节内放置万古霉素治疗膝关节革兰阳性菌感染,效果明显,疗效确切,有创伤小、药物局部应用毒副作用小、安全可靠、恢复快等优点。Objective： To investigate the efficacy of arthroscopic debridement combined with application of vancomycin in the joint for the treatment of Gram-positive bacterial infection in the knee joint. Methods： The data from 17 cases of patients with Gram-positive bacterial infection in knee joint were retrospectively analyzed. They were treated with arthroscopie debridement combined with vancomycin placed in the joint. A closed surgical incision was performed and no lavage was performed after the operation combined with postoperative rehabilitation exercises and comprehensive treatment. Results： All patients were followed up for 6-32 months. There were 15 cases of patients with disappearance of infection symptoms, and 2 cases who needed to undergo second arthroscopic surgery and their postoperative infection was controlled well. Signs of infection recurrence were not found during follow-up in all the patients. Conclusion： Arthroscopic debridement combined with intra- articular administration of vancomycin for the treatment of Gram-positive bacterial infection in knee joint possesses obvious and clear effect with smaller trauma, lower incidence of adverse reactions due to local administration of vancomycin, and reliable safety and quick recovery.

关 键 词：关节镜 膝关节感染 微创 万古霉素 

分 类 号：R687.4[医药卫生—骨科学]