髌旁小切口联合负压封闭引流技术治疗膝关节关节内感染的临床效果  

Clinical Effect of Small Parapatellar Incision Combined with V acuum Sealing Drainage in the Treatment of Knee Intra-articular Infection

作　　者：史迎宾[1] 喻斌 王顺利[1] 赵晓博 SHI Yingbin;YU Bin;WANG Shunli;ZHAO Xiaobo(Department of Orthopedics and Bone Oncology,Zhengzhou Orthopedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院骨病骨肿瘤科,河南郑州450052

出　　处：《河南医学研究》2022年第6期1027-1030,共4页Henan Medical Research

摘　　要：目的分析髌旁小切口联合负压封闭引流技术治疗膝关节关节内感染的临床效果。方法选取2012年6月至2019年6月郑州市骨科医院收治的86例膝关节关节内感染患者为研究对象,根据患者就诊时间顺序编号,按随机数表法分为治疗组(n=43)和对照组(n=43)。两组均在治疗前行膝关节穿刺并通过细菌培养明确致病菌,参照药敏试验应用敏感抗生素。对照组通过静脉通路应用敏感抗生素治疗,治疗组应用髌旁小切口下清创,术中不外翻髌骨进行膝关节内清创,术中联合负压封闭引流技术进行负压吸引,术后根据敏感抗生素应用治疗。分析两组患者的临床疗效。结果在随访期末,治疗组的膝关节活动度(ROM)、视觉模拟评分法(VAS)评分以及膝关节评分(HSS)均优于对照组,差异有统计学意义(P<0.05)。治疗组相关炎症指标恢复到正常水平的时间短于对照组,差异有统计学意义(P<0.05)。结论采用髌旁小切口联合负压封闭引流技术治疗膝关节关节内感染具有较好效果,可作为治疗膝关节感染的有效方法。Objective To analyze the clinical effect of small parapatellar incision combined with vacuum sealing drainage in the treatment of knee intra-articular infection.Methods From June 2012 to June 2019,86 patients with knee intra-articular infection treated in Zhengzhou Orthopedic Hospital were divided into treatment group(n=43)and control group(n=43)according to the randon number table method.Both groups underwent knee puncture and bacterial culture before treatment to identify the pathogens,and sensitive antibiotics were applied through drug sensitivity test.The control group was treated with sensitive antibiotics through the venous pathway.The treatment group was treated with debridement under the small incision near the patella without eversion of the patella during the operation,combined with negative pressure sealing drainage technology for negative pressure suction during the operation,and after the operation,the treatment was applied according to sensitive antibiotics.The clinical effects of the two groups were analyzed.Results At the end of the follow-up period,the range of motion(ROM),visual analogue scale(VAS)score and hospital for special surgery(HSS)score of the treatment group were better than those of the control group(P<0.05).The time of knee infection index decline in the treatment group was less than that in the control group(P<0.05).Conclusion The treatment of intra-articular infection of knee joint with small parapatellar incision combined with vacuum sealing drainage has significant curative effect,which is worthy to be used as an effctive method for the treatment of knee joint infection.

关 键 词：膝关节感染 髌旁小切口 负压吸引装置 

分 类 号：R684.3[医药卫生—骨科学]