二期翻修术与一期翻修术治疗全髋关节置换术后细菌培养阴性假体周围感染患者的效果比较  

Comparison of effects of two-stage revision and one-stage revision in treatment of patients with bacterial culture-negative periprosthetic infection after total hip arthroplasty

作　　者：张成 ZHANG Cheng(Jiamusi Orthopaedic Hospital,Jiamusi 154002 Heilongjiang,China)

机构地区：[1]佳木斯骨科医院,黑龙江佳木斯154002

出　　处：《中国民康医学》2022年第13期153-156,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较二期翻修术与一期翻修术治疗全髋关节置换术后细菌培养阴性假体周围感染患者的效果。方法:选取2020年1月至2021年10月该院收治的70例全髋关节置换术后细菌培养阴性的假体周围感染患者进行前瞻性研究,按随机数字表法将其分为对照组(n=35)和观察组(n=35)。对照组行一期翻修术治疗,观察组采用二期翻修术治疗,治疗6周后,比较两组治疗效果、治疗前后髋关节功能(Harris)评分、疼痛程度[视觉模拟评分法(VAS)]评分、炎性指标[C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞计数(WBC)]水平和并发症发生率。结果:观察组治疗总有效率为97.14%(34/35),高于对照组的77.14%(27/35),差异有统计学意义(P<0.05);治疗后,观察组Harris评分高于对照组,VAS评分低于对照组,差异均有统计学意义(P<0.05);观察组CRP、ESR、WBC水平均低于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:二期翻修术治疗全髋关节置换术后细菌培养阴性假体周围感染患者可提高治疗总有效率和Harris评分,以及改善CRP、ESR、WBC水平,降低VAS评分和并发症发生率,其效果优于一期翻修术治疗。Objective: To compare effects of two-stage revision and one-stage revision in treatment of patients with bacterial culturenegative periprosthetic infection after total hip arthroplasty. Methods: From January 2020 to October 2021, 70 patients with periprosthetic infection with negative bacterial culture after total hip replacement were selected for a prospective study, and were divided into control group(n=35) and observation group(n=35) according to the random number table method. The control group received one-stage revision surgery, while the observation group received two-stage revision surgery. After 6 weeks of treatment, the treatment effects, the hip joint function(Harris) score, the pain level visual analogue scale(VAS) score, the inflammatory index levels [C-reactive protein(CRP), erythrocyte sedimentation rate( ESR), white blood cell(WBC)],and the incidence of complications were compared between the two groups. Results: The total effective rate of treatment in the observation group was 97.14%(34/35), which was higher than that the control group of 77.14%(27/35), and the difference was statistically significant(P<0.05). After the treatment, Harris score in the observation group was higher than that in the control group;the VAS score was lower than that in the control group;and the differences were statistically significant(P<0.05). The levels of CRP, ESR and WBC in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). Further, the incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusions: The two-stage revision surgery for the patients with bacterial culture-negative periprosthetic infection after total hip arthroplasty can improve the total effective rate of treatment and the Harris score and reduce the CRP, ESR, WBC levels, the VAS score and the incidence of complications. Moreover, it is superior to one-stage revision surgery.

关 键 词：翻修术 全髋关节置换术 假体周围感染 HARRIS评分 并发症 

分 类 号：R687.4[医药卫生—骨科学]