全膝关节置换后假体周围感染病原菌分布特点及治疗策略  

Periprosthetic joint infection following total knee arthroplasty: its bacteriological characteristics and treatment strategies

作　　者：崔苛苛 杨伟毅 刘军 潘建科 张葆青 曹学伟 

机构地区：[1]广州中医药大学第二临床医学院,广东省广州市510000 [2]广州中医药大(学第二附属医院(广东省中医院)骨科,广东省广州市510000

出　　处：《中国组织工程研究》2017年第35期5721-5726,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81473698);教育部高等学校博士点科研基金项目(20124425110004);广东省科技计划项目(2011B031700027);广东省财政厅项目([2014]157号);广东省中医药管理局项目(20164020);广东省中医院中医药科学技术研究专项(YK2013B2N19;YN2015MS15)~~

摘　　要：背景:全膝关节置换后假体周围感染已成为术后严重并发症之一,但目前缺少对主要致病菌分布情况的阐述及临床研究,统计并分析主要致病菌的分布特点成为早期防治术后感染的基础。目的:分析国内外全膝关节置换术后假体周围感染的细菌学分布特点,以期为临床充分把握主要致病菌分布特点及早期预防和治疗提供参考。方法:检索中国知网、维普、万方、Pub Med数据库建库至2016年有关全膝关节置换术后假体周围感染的临床研究及文献报道,统计分析有关全膝关节置换术后假体周围感染的发生情况。结果与结论:(1)共有103篇文献入选,统计1 399例全膝关节置换术后假体周围感染的患者;(2)感染细菌以金黄色葡萄球菌、凝固酶阴性葡萄球菌、表皮葡萄球菌、大肠埃希菌、链球菌及肠球菌属等多见;国内外细菌分布对比差异无显著性意义;治疗方法以保守及手术治疗为主;(3)综上,充分把握全膝关节置换术后假体周围感染细菌分布情况,多学科团队合作采取预防措施和诊断,合理选择治疗方案,才能最终实现根除感染、保留关节功能的目的。BACKGROUND： Periprosthetic infection after total knee arthroplasty （TKA） has become the most serious complication. However, there is still a lack of clinical study on the distribution of pathogenic bacteria. Therefore, understanding the distribution characteristics of the main pathogenic bacteria is critical for preventing and treating OBJECTIVE： To analyze the bacteriological characteristics in the patients with periprosthetic joint infection following TKA, so as to provide reference for early prevention and treatment. METHODS： CNKI, VIP, WanFang and PubMed databases were retrieved for the literature concerning periprosthetic infection following TKA published before 2016. The incidence of periprosthetic joint infection after TKA was statistically analyzed. RESULTS AND CONCLUSION： （1） 103 articles were included, involving 1 399 patients. （2） The main pathogenic bacteria were Staphylococcus aureus,coagulase negative Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli, Streptococcus and Enterococcus.There is no significant difference in the distribution of bacteria at home and abroad. Treatment strategies are divided into conservative and surgical treatments. （3） The key for successfully preventing and treating periprosthetic infection after TKA lies in the multiple disciplinary team collaboration, understanding the distribution of bacteria, early diagnosis and active preventive measurements, as well as rational treatment strategies.

关 键 词：骨科植入物 人工假体 全膝关节置换术 感染 细菌 病原菌 治疗 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]